中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (13): 2459-2462.doi: 10.3969/j.issn.1673-8225.2012.13.041

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

人工髋关节置换后感染的细菌培养及治疗对策文献复习 

周生瑞，苗  胜，沙广钊   

  1. 邳州市人民医院，江苏省邳州市221300
  • 收稿日期:2012-01-07 修回日期:2012-02-06 出版日期:2012-03-25 发布日期:2012-03-25
  • 作者简介:周生瑞，男，1976年生，江苏省丰县人，汉族，2001年南京医科大学毕业，主治医师，主要从事关节和脊柱研究。 zhoushengrui512@126.com

Bacterial culture and treatment strategy of infection after total hip replacement: Review of the literature 

Zhou Sheng-rui, Miao Sheng, Sha Guang-zhao   

  1. Pizhou City People's Hospital, Pizhou  221300, Jiangsu Province, China
  • Received:2012-01-07 Revised:2012-02-06 Online:2012-03-25 Published:2012-03-25
  • About author:Zhou Sheng-rui, Attending physician, Pizhou City People's Hospital, Pizhou 221300, Jiangsu Province, China zhoushengrui512@126.com

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摘要：

背景：人工髋关节置换后假体周围感染是最严重的并发症之一。
目的：探讨人工髋关节置换后感染的原因分析及治疗对策的文献复习。
方法：回顾性分析18例人工髋关节置换后感染患者的致病菌培养，并回顾治疗对策。
结果与结论：18例患者人工髋关置换后平均随访25(12~48)个月：6例清创后保留假体，5例一期翻修者中1例清创复发再次清创伤口愈合；7例使用抗生素骨水泥二期翻修者，置换后25个月未见复发；所有患者伤口完全愈合，末次随访时均未见感染复发。髋关节Harris评分由置换前平均43.25分提高到86.5分。18例人工髋关节置换后感染的病原菌为：表皮葡萄球菌6例，金黄色葡萄球菌4例，阴沟肠杆菌3例，铜绿假单胞菌2例，溶血性链球菌1例，大肠杆菌2例。
关键词：感染；人工髋关节置换；对策；原因；翻修
doi:10.3969/j.issn.1673-8225.2012.13.041

关键词: 感染, 人工髋关节置换, 对策, 原因, 翻修

Abstract:

BACKGROUND: Periprosthetic infection after total hip replacement is one of the most serious complications.
OBJECTIVE: To investigate the cause of infection after total hip replacement and to review the literature of treatment strategy.  
METHODS: A retrospective analysis of pathogenic cultures on 18 infection cases after total hip replacement and review the treatment strategy.
RESULTS AND CONCLUSION: Twenty-five (12-48) months follow-up of 18 patients after total hip replacement showed that there were six patients retained the prosthesis after debridement, five patients were preformed with one-stage revision, and among the five patients, only one case of recurrence after debridement and clear trauma again and finally the wound was healed; seven patients were preformed with two-stage revision using antibiotic bone cement and there was no recurrence in 25 months after total hip replacement; the wound of all the patients were healed completely and there was no recurrent infection in the final follow-up. The Harris score of the hip was changed from the 43.25 points preoperatively to 86.5 points postoperatively. The infected pathogenic bacteria of 18 patients after total hip replacement included six cases of staphylococcus epidermidis, four cases of staphylococcus aureus, three cases of enterobacter cloacae, two cases of pseudomonas aeruginosa, one case of hemolytic streptococcus and two cases of escherichia coli. 

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