摘要
目的总结人工髋关节感染的诊断及治疗方法.方法回顾性分析1975年5月至2004年12月收治的人工髋关节置换术后感染患者43例44髋的临床资料,其中男25例26髋,女18例18髋;本院感染病例16例16髋,外院感染病例27例28髋,平均年龄为54岁(24～81岁).平均随访时间3年3个月(5个月～16年).治疗包括:Ⅰ期翻修7例,其中2例失败后行切除成形术;Ⅱ期翻修15例16髋,切除成形13例;保留假体清创5例;抗生素治疗、髋关节融合和截肢各1例.43例患者中40例术前和术中培养阳性,共培养出59株细菌,其中表皮葡萄球菌19株,金黄色葡萄球菌10株.结果术后随访36例,感染均无复发.29例进行术后Harris评分,平均为78.5分(45～98分).结论人工髋关节置换术后感染诊断治疗均很困难,细菌毒力高、耐药率高,治疗时应予以重视,治疗方法选择应根据具体情况而定,以Ⅱ期翻修较为理想.
Objective To present the experience in the management of the infected total hip arthroplasty （ THA ）. Methods Forty-three cases （ 44 hips ） of infection after THA were reviewed. Eighteen women and 25 men with a mean age of 54 years （range, 24-81 years） were studied. Follow-up ranged from 5 months to 16 years （mean, 3.2 years）. Treatment strategies included： one-stage revision （ n=7 ）, two-stage revision （ n=15 ）, resection arthroplasty （ n=13 ）, debridement and retain prothesis （n=5 ）, and others （n=3 ）. Results Forty cases had positive culture result with 59 organisms including 19 staphylococcus epidermidis and 10 staphylococcus aureus. Thirty-six cases had been followed up, and no case had infection recurrence. Twenty-nine cases had postoperative Harris hip score averaged 78. 5 （45-98）. Conclusions The diagnosis and treatment of infection after hip replacement is very difficult. The violence and antibiotic resistant rate of the organisms is high. Two-stage reconstruction of the infected hip is useful and effective because of higher eradication rate of the infection and good postoperative functional result.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2005年第20期1313-1316,共4页
Chinese Journal of Surgery
关键词
关节成形术
置换
髋
感染
治疗结果
Arthroplasty, replacement, hip
Infection
Treatment outcome
