在儿童骨关节感染中进行高级成像的最佳时机
Sarah Hunter1,2, Elsie Brown2, Haemish Crawford1,2
1Department of Paediatric Orthopaedics, Starship Children's Hospital, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Journal of pediatric orthopedics
|September 23, 2024
概括
在为儿童骨关节感染 (BJI) 进行手术前进行磁共振成像 (MRI) 减少了重新手术的发生率. 在入院后48小时内早期的MRI也可以缩短非手术病例的住院时间.
科学领域:
- 儿科整形外科 儿科整形外科
- 儿童传染病 儿童传染病
- 诊断成像 诊断成像 诊断成像
背景情况:
- 先进的成像,特别是磁共振成像 (MRI),在治疗儿童骨关节感染 (BJI) 中发挥着至关重要的作用.
- 针对儿科BJI的手术和非手术治疗策略,MRI的最佳时间尚不清楚.
- 了解MRI时间的影响对于改善治疗结果至关重要,包括减少手术,停留时间和成本.
研究的目的:
- 调查MRI时间对手术管理,停留时间 (LOS),住院费用和儿科BJI疾病复发的影响.
- 为了确定手术前的MRI是否会影响手术后的MRI与手术前的MRI相比,重新手术的发生率.
- 评估早期MRI (入院后48小时内) 在非手术治疗的BJI病例中对LOS的影响.
主要方法:
- 从2018年到2023年,对被诊断患有急性血源性骨质炎 (AHO) 或败血性关节炎 (SA) 的儿科患者 (<16岁) 的回顾性评估.
- 纳入标准侧重于在诊断工作期间使用MRI的病例.
- 收集的数据包括治疗方法,入院到MRI的时间,LOS,住院费用和感染复发率.
主要成果:
- 在390个符合条件的BJI病例中 (主要是AHO),MRI使用在2018年至2023年期间从54%增加到80%.
- 术前MRI (n=145) 与术后MRI (n=60) 相比,与明显较低的重复手术率 (33%对77%) 和较短的LOS (14.1对22.4天) 相关.
- 对于非手术性病例,入院后48小时内的MRI与较短的LOS (7.3 vs. 10天) 相相关. 疾病复发与MRI时间不相关.
结论:
- 在小儿BJI病例中进行MRI手术前进行MRI与重新手术率的降低有关.
- 在入院后48小时内,早期的MRI给药与非手术治疗的BJI儿童的住院时间缩短有关.
- 核磁共振成像的时间似乎是优化儿童骨和关节感染的管理和资源利用的一个重要因素.
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