假体周围感染讲解课件.pptx

PJI术后，如何使用抗生素？浙江中医药大学附属第一医院童培建2017.09.03什么是PJI关节假体周围感染（Periprosthetic joint infection，PJI），发生于关节置换术后，以膝关节（2%）、髋关节（0.45-0.57%）多见。Two-stage Revision for Periprosthetic Hip and Knee Joint Infections. The open orthropaedics journal. 2017Biofilm and the Role of Antibiotics in the Treatment of Periprosthetic Hip and Knee Joint Infections. The Open Orthopaedics Journal, 2016PJI诊断标准（AAOS标准）存在于假体相通的窦道受累人工关节部位2处组织或关节液样本中分离出同一病原体以下4条满足3条或以上ESR或CRP水平升高滑膜或关节液白细胞升高滑膜或关节液中性粒细胞百分比升高组织或关节液单次细菌培养阳性* Principles of Antibiotic Prophylaxis in Total Joint Arthroplasty: Current Concepts. JAAOS-D-15-00017,2016 PJI临床表现急性红肿热痛，切口不愈合PJI夜间痛，休息痛窦道形成脓液流出慢性Two-stage Revision for Periprosthetic Hip and Knee Joint Infections. The open orthropaedics journal. 2017Biofilm and the Role of Antibiotics in the Treatment of Periprosthetic Hip and Knee Joint Infections. The Open Orthopaedics Journal, 2016PJI常见病原菌病原菌主要来源于血液及皮肤Ⅱ、Ⅲ类感染金黄色葡萄球菌Ⅳ类感染凝固酶隐性葡萄球菌*初次人工全膝关节置换术后假体周围感染的病原菌分布及药敏分析. Chinese Journal of Reparative and Reconstructive Surgery. 2014生物膜-PJI药物治疗的关键病原体基质多糖聚合物蛋白DNA普遍存在难以清除Biofilm and the Role of Antibiotics in the Treatment of Periprosthetic Hip and Knee Joint Infections. The Open Orthopaedics Journal, 2016The role of microbial biofilms in prosthetic joint infections A review. Acta Orthopaedica 2015抗生素抗体吞噬细胞生物膜DNA片段生物膜内容物聚集细菌骨 科 内 植 物Correlation between in vivo in vitro efficacy of antimicrobial agent against foreign body infection, Rev Infect Dis.江荣林院长授课摘录Biofilm and the Role of Antibiotics in the Treatment of Periprosthetic Hip and Knee Joint Infections. The Open Orthopaedics Journal, 2016The role of microbial biofilms in prosthetic joint infections A review. Acta Orthopaedica 2015PJI分期 根据术后PJI发生的时间，可分为早期感染、迟发感染、晚期感染。早期感染：3个月迟发感染：3--24个月晚期感染：24个月行清创术是否行清创术视具体情况而定* An update on surgical and antimicrobial therapy for acute periprosthetic joint infection: new challenges for the present and the future. Expert Rev Anti Infect Ther. 2015.PJI 2017年SIMIC治疗指南* Executive summary of management of prosthetic j