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在儿科败血性关节炎中重复排水的风险:患者还是方法?
Julia Royer1, Louis-Charles Castel1, Yan Lefevre1
1Department of Pediatric Surgery, Pellegrin University Hospital, Bordeaux.
Journal of pediatric orthopedics. Part B
|August 23, 2023
概括
关节切除术 (Ac) 和关节切除术 (At) 在儿科败血性关节炎排水中同样有效. 相关的肌肉骨感染,毒性细菌和阳性血培养增加了重复排水的需要.
科学领域:
- 儿科整形外科 儿科整形外科
- 传染性疾病 传染性疾病
- 手术技巧 手术技巧
背景情况:
- 对于儿科的部和膝盖病例,包括关节切开 (Ac) 和关节切开 (At) 在内的败血性关节炎排水方法正在讨论中.
- 识别重复排水的风险因素对于优化治疗结果至关重要.
研究的目的:
- 为了比较Ac与At的疗效,作为儿科败血性关节炎的第一线治疗.
- 确定与需要第二次关节排水程序相关的风险因素.
主要方法:
- 儿科患者 (2014-2020年) 败血性关节炎和积极的关节液培养物的回顾性审查.
- 用Ac和At治疗的患者之间的结局的比较,分析需要重复排水的需求.
- 统计分析以确定二次排水的风险因素,包括相关的肌肉骨感染 (MSI),细菌毒性和血液培养结果.
主要成果:
- 在Ac和At之间的重复排水率上没有显著的差异.
- 关联的肌肉骨感染 (MSI) 是重复排水的重要危险因素 (OR=11.8).
- 需要更频繁地进行重复排水的患者有MSI,I级毒性细菌和阳性血液培养.
结论:
- 关节切开术和关节切除术都是对儿科败血性关节炎的可行的第一线治疗方法,其重复排水率相似.
- 关联的肌肉骨感染,毒性微生物菌株和阳性血液培养是预测需要重复关节排水的关键风险因素.
- 进一步的研究可能将重点放在基于已识别的风险因素的量身定制治疗策略上,以尽量减少重复干预.
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