摘要
目的探讨关节镜前交叉韧带(ACL)重建术后感染病人的临床特点,以便更好地指导其临床诊治。方法回顾性分析2012年2月—2019年10月在我院行关节镜ACL重建术后发生感染11例病人的临床资料。结果 11例病人术后感染的病原菌以表皮葡萄球菌为主(54.55%);临床表现主要为发热(90.91%)和膝关节疼痛(100.00%);实验室检查C-反应蛋白(CRP)>50 mmol/L者7例(63.64%),血红细胞沉降率(ESR)>50 mm/1 h者6例(54.55%)。所有病人均行静脉应用抗生素联合关节镜下膝关节腔清理与置管冲洗引流治疗。术前与治疗1、7、14 d时的CRP比较,差异有统计学意义(F=3.965,P<0.01),ESR则差异无显著性(P>0.05)。治疗前与末次随访时的患膝Lysholm评分和膝关节活动度(ROM)比较,差异具有统计学意义(t=15.963、24.769,P<0.01)。结论关节镜ACL重建术后感染病原菌以表皮葡萄球菌为主,首先表现为发热与患膝突发疼痛,静脉应用抗生素联合关节镜下膝关节腔清理可获得满意的临床疗效。
Objective To explore the clinical features of patients with postoperative infection after arthroscopic anterior cruciate ligament(ACL) reconstruction, and to guide its clinical diagnosis and treatment better. Methods A retrospective ana-lysis was performed on the clinical data of 11 patients with postoperative infection after arthroscopic ACL reconstruction in The Affiliated Hospital of Qingdao University from February 2012 to October 2019. Results Staphylococcus epidermidis was the main pathogen(54.55%) in the 11 patients, and the main clinical manifestations were fever(90.91%) and knee pain(100.00%). The laboratory examinations showed that there were 7 cases(63.64%) with C-reaction protein(CRP)>50 mmol/L, and 6 cases(54.55%) with erythrocyte sedimentation rate(ESR)>50 mm/1 h. All patients were treated with intravenous antibiotics combined with arthroscopic joint debridement and catheter drainage. There was a significant difference in CRP between different time points(before operation and 1,7, and 14 days after treatment)(F=3.965,P<0.01), while there was no significant difference in ESR between different time points(P>0.05). There were significant differences in Lysholm score and knee joint range of motion between pre-treatment and last follow-up(t=15.963,24.769;P<0.01). Conclusion Staphylococcus epidermidis is the main pathogen after arthroscopic ACL reconstruction, and the initial manifestations are fever and sudden pain in the affected knee. The application of intravenous antibiotics combined with arthroscopic knee joint debridement can achieve satisfactory clinical effects.
作者
徐奎帅
张靓
戚超
高甲科
李海峰
于腾波
XU Kuishuai;ZHANG Liang;QI Chao;GAO Jiake;LI Haifeng;YU Tengbo(Department of Sports Medicine,The Affiliated Hospital of Qingdao University,Qingdao 266100,China)
出处
《青岛大学学报（医学版）》
2021年第5期671-674,共4页
Journal of Qingdao University(Medical Sciences)
基金
国家自然科学基金资助项目(31872310)。
关键词
前交叉韧带重建
关节镜检查
感染
手术后期间
治疗
anterior cruciate ligament reconstruction
arthroscopy
infections
postoperative period
therapy
