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高度连续局部抗菌输液疗法:急性和慢性周围假肢膝关节感染的安全性和潜在疗效

Yuki Suzuki¹, Koji Iwasaki², Zenta Joutoku³

¹Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 jo, Nishi 7 chome, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.

|November 26, 2024

概括

连续局部抗生素输液 (CLAP) 治疗在全膝关节整形术 (TKA) 后对周围假肢关节感染 (PJIs) 的治疗有希望. 这种方法与传统治疗相结合,在最近的一项研究中证明了安全性和有效性.

科学领域:

整形外科手术整形外科手术
传染病传染病传染病
药理学药理学是指药理学的学科.

背景情况:

在全膝关节整形术 (TKA) 后的周围假肢关节感染 (PJIs) 存在重大管理挑战.
持续局部抗生素输液 (CLAP) 治疗是肌肉骨感染的新兴治疗方法.

研究的目的:

评估CLAP治疗的结果和风险,当与PJI的TKAs常规治疗一起使用时.

主要方法:

在TKA后对14名PJI患者的回顾性分析.
对于急性PJIs,CLAP治疗与除菌,静脉注射抗生素和植入物保留相结合.
慢性PJIs的CLAP治疗与两阶段修复手术,包括为期3个月的抗生素排泄水泥间隔器.
通过CLAP,与外科手术期间的静脉注射抗生素一起,在2周内局部给药 (120毫克/天).

主要成果:

五名急性PJI患者接受了一阶段手术和CLAP治疗,保留了他们的植入物.
在9名慢性PJI患者中,有7名接受了CLAP和两阶段修订治疗,取得了成功的结果.
两名慢性PJI患者最初接受了一阶段手术治疗,CLAP需要随后的两阶段修订,这是成功的.
没有报告与 gentamicin 管理相关的不良反应.

结论:

在TKA之后,CLAP疗法似乎是治疗急性和大多数慢性PJI的安全和有效补充剂.
这些发现支持使用CLAP治疗来治疗复杂的膝关节关节感染.

关键词:

连续的局部抗生素 perfusion perfusion 是一种持续的局部抗生素 perfusion.这是一种 gentamicin.感染感染感染周围假肢关节感染整体膝关节关节整形术膝关节整形术

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