全髋关节置换术后深部感染的诊断及二期翻修技术的探讨Diagnosis of deep infection after total hip arthroplasty and exploration of its second revision.pdfVIP

提 要 目的：探讨全髋关节置换术后深部感染的诊断，及二期翻修的方法。消除患者临 床症状，改善关节功能，保证生活质量。 方法：本研究病例来自山东中医药大学附属医院关节骨科病房，共收集自 2010 年12月～2012年2月全髋关节置换术后深部感染11例,其中男7例，女4例，年龄 51～72 岁，平均 63 岁，左侧 5 例,右侧 6 例。对所有病例采用了切开取出假体、清 理病灶、旷置、择期二期翻修的治疗方法。翻修术后三个月及一年随访时，采用Harris 髋关节功能评分标准进行评分，观察疗效。 结果：11例患者，术后三个月：优4例，良3例，可2例，差2例，优良率63.6%； 术后一年：优7例，良3例，可1例，差0例，优良率90.9%。 结论：全髋关节置换术后深部感染的诊断和治疗都是困难的，采用二期翻修术， 具有容易控制感染，及时消除感染灶，安全系数高的优点，临床疗效满意。 关键词 全髋关节置换；深部感染；诊断；二期翻修术 The Research for Diagnosis of Deep Infection after Total Hip Arthroplasty and Technology of Two-stage Revision Speciality: Orthopaedics of Traditional Chinese Medicine Author: Zhang Hao Tutor: Prof.Zhang Shi Hua Abstract Objective: Discussion on diagnosis of deep infection after total hip arthroplasty and method of two-stage revision.Elimination of clinical symptoms, improve joint function, ensuring the quality of life. Methods: This study from Shandong university of traditional chinese medicine affiliated hospital joint orthopedic ward, collected 11 cases of deep infection after total hip arthroplasty from December 2010 to February 2011. Included 7 males and 4 females, age 51 to 72 years old, on average, 63 years old, the left 5 cases, right 6 cases. All cases were used the incision to take out the prosthesis, clean up lesions, exclusion and selective two-stage revision for treatment methods. They were followed up when the three month and one year after revision, used the Harris hip score criteria for scoring, and observe the curative effect. Results: In 11 cases, three months after operation:excellent in 4, good in 3, fair in 2 , poor in 2, excellent and good rate of 63.6%;one year after operation: excellent in 7, g