关节镜清理联局部应用万古霉素治疗17例膝关节革兰阳性菌感染疗效观察.docVIP

关节镜清理联合局部应用万古霉素治疗17例膝关节革兰阳性菌感染疗效观察 　　摘 要 目的：探讨关节镜下彻底清理联合关节内放置万古霉素治疗膝关节革兰阳性菌感染疗效。方法：回顾性分析膝关节革兰阳性菌感染患者17例，均采用关节镜清理结合关节内放置万古霉素进行治疗，一期闭合手术切口，术后不置管进行灌洗，配合术后康复锻炼综合治疗。结果：所有患者随访6 ～32个月，15例患者感染症状消失，2例患者进行了第2次关节镜手术，术后感染得到良好控制；在随访期间所有患者均无复发感染迹象。结论：关节镜下彻底清理联合关节内放置万古霉素治疗膝关节革兰阳性菌感染，效果明显，疗效确切，有创伤小、药物局部应用毒副作用小、安全可靠、恢复快等优点。 中国论文网 /6/viewhtm　　关键词 关节镜 膝关节感染 微创 万古霉素 　　中图分类号：R684.3； R605 文献标识码：B 文章编号：1006-1533（2017）19-0038-03 　　Clinical effect of arthroscopic debridement combined with topical application of vancomycin in the treatment of 17 cases of Gram-positive bacterial infection in knee joint 　　FANG Yonggang* 　　（Department of Orthopaedics， the Ninety-one Central Hospital of PLA， Jiaozuo 454003， China） 　　ABSTRACT Objective： To investigate the efficacy of arthroscopic debridement combined with application of vancomycin in the joint for the treatment of Gram-positive bacterial infection in the knee joint. Methods： The data from 17 cases of patients with Gram-positive bacterial infection in knee joint were retrospectively analyzed. They were treated with arthroscopic debridement combined with vancomycin placed in the joint. A closed surgical incision was performed and no lavage was performed after the operation combined with postoperative rehabilitation exercises and comprehensive treatment. Results： All patients were followed up for 6～32 months. There were 15 cases of patients with disappearance of infection symptoms， and 2 cases who needed to undergo second arthroscopic surgery and their postoperative infection was controlled well. Signs of infection recurrence were not found during follow-up in all the patients. Conclusion： Arthroscopic debridement combined with intraarticular administration of vancomycin for the treatment of Gram-positive bacterial infection in knee joint possesses obvious and clear effect with smaller trauma， lower incidence of adverse reactions due to local administration of vancomycin， and reliable safety and quick recovery. 　　KEY WORDS arthroscopy； kn