中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (43): 8137-8141.doi: 10.3969/j.issn.1673-8225.2011.43.038

• 骨与关节学术探讨 academic discussion of the bone and joint • 上一篇    下一篇

全膝关节置换后的感染防治

何  生1，曾意荣2   

  1. 1广州中医药大学第一临床医学院，广东省广州市  510405
    2广州中医药大学第一附属医院，广东省广州市  510405
  • 收稿日期:2011-05-26 修回日期:2011-06-29 出版日期:2011-10-22 发布日期:2011-10-22
  • 通讯作者: 曾意荣，博士，主任医师，硕士生导师，广州中医药大学第一附属医院关节一科，广东省广州市 510405
  • 作者简介:何生★，男，1985年生，江西省赣州市人，汉族，广州中医药大学在读硕士，主要从事髋膝关节疾病的研究。

Prophylaxis and treatment for infection following total knee replacement

He Sheng1, Zeng Yi-rong2   

  1. 1First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou  510405, Guangdong Province, China
    2First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou  510405, Guangdong Province, China
  • Received:2011-05-26 Revised:2011-06-29 Online:2011-10-22 Published:2011-10-22
  • Contact: Zeng Yi-rong, Doctor, Chief physician, Master’s supervisor, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • About author:He Sheng★, Studying for master’s degree, First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China

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摘要：

背景：感染造成的骨缺损、骨质疏松、皮肤伤口问题以及多次清创后导致的软组织丢失和瘢痕增生使翻修变得非常困难。
目的：综述全膝关节置换后感染的预防、诊断、有效治疗及康复评价的最新进展，从而建立标准化的临床预防与治疗机制。
方法：应用计算机检索1990-01/2010-12 CNKI数据库、Pubmed数据库相关文章，检索词为“total knee arthroplasty, infection”共检索到文献2 346篇，并参阅其他相关的著作，最终纳入符合标准的文献30篇。
结果与结论：感染的预防比感染的治疗更为有效。目前在诊断上，还缺乏明确诊断的特异性指针。在治疗上，彻底清创、选择有效抗生素及翻修术能够有效地治疗感染。同时新方法的应用有望提高全膝置换后感染的成功率。康复锻炼是治疗延续，也是治疗的重要步骤。为此，在全膝关节置换的基础上应该建立置换后感染的早期预防、早期诊断、有效治疗及康复评价体系，以尽量减少感染的发生及对感染进行及时有效的治疗。

关键词: 全膝关节置换, 感染, 早期预防, 早期诊断, 有效治疗, 康复

Abstract:

BACKGROUND: It is difficult to revise replacement due to infection-induced osteodeficiency, osteoporosis, soft tissue lost or cicatrization.
OBJECTIVE: To establish the standardized clinical prevention and treatment methods by summarizing the new progress to prevent, diagnosis of the infection, and its effective treatment, as well as rehabilitation evaluation after total knee replacement.
METHODS: A computer-based online search of CNKI and PUBMED database between January 1990 and December 2010 was performed to search related articles with the key words of “total knee arthroplasty, infection”. A total of 2 346 articles were retrieved. Moreover, related works were manually searched. Totally, 30 articles were included.
RESULTS AND CONCLUSION: It is better to prevent infection rather than treatment after total knee replacement. Currently, there is lack of a clear diagnosis standard on the infection. In treatment aspect, debridement, revision surgery, and choosing effective antibiotics can effectively control the infection. Meantime, new methods are expected to improve the success rate of infection after total knee replacement. Exercise is a continuation of rehabilitation therapy and an important step in treatment. Therefore, on the basis of total knee replacement, it is important to establish the early prevention of postoperative infection, early diagnosis, effective treatment and rehabilitation evaluation system, in order to minimize the incidence of infection and treat infections timely and effectively.

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