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逆肩关节整形术后延迟周围假肢关节感染的连续局部抗生素输液 (CLAP) 一阶段修复成功:一个案例报告
Jin Nagasawa1, Yoshihiro Hirakawa1,2, Katsumasa Nakazawa2
1Orthopaedic Surgery, Ishikiriseiki Hospital, Higashiōsaka, JPN.
Cureus
|January 29, 2026
概括
持续局部抗生素 perfusion (CLAP) 提供了一个有前途的解决方案,在逆肩关节整形术 (RSA) 后治疗具有挑战性的周围假肢关节感染 (PJI). 这一案例证明了使用CLAP与一阶段修复手术一起成功管理PJI.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 生物医学工程 生物医学工程
背景情况:
- 周围假肢关节感染 (PJI) 是逆肩关节整形术 (RSA) 后的一个重大并发症.
- 延迟和慢性PJIs带来治疗挑战,通常需要复杂的手术干预.
- 耐多药生物复杂化了感染管理,需要创新的治疗方法.
研究的目的:
- 报告在逆肩关节整形术 (RSA) 后成功治疗延迟周围假肢关节感染 (PJI) 的病例.
- 评估持续局部抗生素 perfusion (CLAP) 的疗效,作为肩膀PJI的一阶段修复手术的辅助.
- 突出多药耐药生物体引起的PJI的管理.
主要方法:
- 在RSA后患有慢性PJI的72岁男性患者接受了一阶段修改手术.
- 该程序包括脱bridement,植入物交换和连续局部抗生素 perfusion (CLAP) 与 gentamicin.
- 手术后的管理涉及负压伤口治疗 (NPWT) 与珍塔米辛输液和静脉注射抗生素.
主要成果:
- 患者经历了感染症状的快速消失,在一年的随访中没有复发.
- 成功管理扩展谱β-乳糖酶 (ESBL) 生产的Klebsiella oxytoca和金黄色葡萄球菌感染.
- 实现了显著的功能恢复,JOA得分为69和良好的运动范围.
结论:
- 持续局部抗生素输液 (CLAP) 可以成为肩膀PJI的一阶段修复手术的有效补充.
- 这种方法甚至在涉及多抗药生物体的情况下也显示出前景.
- 在肩膀关节整形术中,CLAP是管理复杂的周围假肢关节感染的有价值的策略.
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