[在免疫调节疗法下进行关节置换期间的感染]
Stefan Rehart1, Ole Schickedanz2, Benedikt Wickler1
1Klinik für Orthopädie und Unfallchirurgie, AGAPLESION MARKUS KRANKENHAUS, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Deutschland.
Zeitschrift fur Rheumatologie
|April 2, 2025
概括
人工关节置换是常见的,但周围假肢感染 (PPI) 是一个风险,特别是在免疫抑制患者. 早期诊断和跨学科管理是预防和治疗这些严重并发症的关键.
科学领域:
- 整形外科手术 整形外科手术
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
背景情况:
- 人工关节置换是对退行性和炎症性关节疾病的标准治疗方法.
- 增加的内置假肢手术与术后并发症的风险更高相关,特别是周围假肢感染 (PPI).
- 接受免疫抑制治疗的类风湿病患者面临PPI风险升高,原因是免疫反应受损.
研究的目的:
- 突出在接受人工关节置换的免疫抑制患者中管理周围假肢感染的挑战和重要性.
- 强调需要进行术前风险评估和术后管理策略.
- 强调跨学科方法的必要性,以获得最佳的患者结果.
主要方法:
- 在免疫抑制的背景下对周围假肢感染的当前理解的审查.
- 讨论免疫受损患者的诊断挑战.
- 强调了手术前优化和跨学科合作的作用.
主要成果:
- 免疫抑制药物 (皮质类固醇,DMARDs,生物药物) 显著增加PPI风险.
- 在免疫抑制个体中诊断PPI是困难的,因为症状减弱.
- 早期的个性化治疗,包括抗生素和手术,以及跨学科的管理,至关重要.
结论:
- 积极的手术前措施和仔细调整免疫抑制治疗对于预防感染至关重要.
- 及时诊断和量身定制的治疗策略对于管理疑似PPI至关重要.
- 综合的方法涉及风湿病学家,骨科外科医生和传染病专家,确保有效的管理和改善患者的预后.
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