摘要
急性血源性骨髓炎(AHO)是儿童骨髓炎最常见的类型。近年来,儿童耐甲氧西林金黄色葡萄球菌感染的发生率有所增加,使得感染更加复杂,常常导致深静脉血栓形成、感染性肺栓塞、肺炎、脓胸、心内膜炎、菌血症和感染性休克等并发症的发生。进而导致儿童患者病情更加严重,治疗周期延长。AHO的延迟治疗可能会发展为慢性骨髓炎,导致骨骼生长和发育障碍。因此,早期、准确的诊断和及时治疗仍是治疗AHO的主要原则。另外,对于患有AHO的儿童患者,需要一种有组织、跨学科的方法来达到及时、全面和准确的诊断,这样才能实施有效的治疗。为此,本文综述儿童AHO的发病机制、细菌学、诊断和治疗方面等内容,旨在提供对现有证据和未来发展方向的最新了解,提高对儿童AHO患者的管理水平。
Acute hematogenous osteomyelitis(AHO)is the type of its kind diagnosed most frequently in pediatric patients.In the past decade,the incidence of methicillin-resistant Staphylococcus aureus infections has increased in children.The more complex situation of infections may lead additionally to deep vein thrombosis(DVT),septic pulmonary embolism,pneumonia,empyema,endocarditis,bacteremia and septic shock.Hence,hospital stays are often lengthy and patients often critically ill.Since delayed appropriate therapy can lead to chronic osteomyelitis,as well as impairments in bone growth and development,early accurate diagnosis and prompt initiation of appropriate treatment remain central principles in the evaluation and treatment of AHO.Therefore,care of children with AHO inevitably requires an organized and interdisciplinary approach to reach timely,comprehensive and accurate diagnoses so that effective treatment may be carefully planned and enacted with subsequent monitoring of the child until clinical resolution is achieved.This review is devoted exclusively to the management of AHO in children,providing an update on the current understanding of existing evidence and future directions to improve care for pediatric AHO.
作者
陶锐
覃承诃
方佳
周春豪
孟祥清
Tao Rui;Qin Chenghe;Fang Jia;Zhou Chunhao;Meng Xiangqing(Division of Orthopaedics and Traumatology,Department of Orthopaedics,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Orthopaedics and Traumatology,Guangdong Second Provincial General Hospital,Guangzhou 510317,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2020年第9期818-823,共6页
Chinese Journal of Orthopaedic Trauma
关键词
骨髓炎
感染
诊断
治疗
儿童
Osteomyelitis
Infection
Diagnosis
Treatment
Children
