婴幼儿下肢多关节化脓性感染临床分析

目的探讨婴幼儿下肢多关节化脓性感染的临床特点及治疗方法。方法回顾性分析3例下肢多关节化脓性感染患儿的病史特点、临床表现、治疗方法及预后。结果本组病变累及膝关节4个,髋关节3个;髋关节病变者患肢屈曲、外展,自主活动减少或无;膝关节病变者有关节肿胀,局部皮温增高,浮髌试验阳性;3例均行感染关节切开引流术并应用抗生素治疗,术后随访3~5a,2例下肢功能恢复良好,1例遗留双侧髋关节病理性脱位。结论婴幼儿出现多关节肿胀、活动受限、疼痛时应考虑有多关节化脓性感染可能,及时行关节腔穿刺及关节切开引流术可防止漏、误诊及病变关节的不可逆损害。

Clinical analysis of lower extremity polyarticular septic arthritis in infants

Objective To explore the clinical characteristics,clinical manifestations,treatment methods and prognosis of lower extremity polyarticular septic arthritis in infants.Methods The history characteristics,clinical manifestation,treatment and prognosis were retrospectively analyzed in 3infants with lower extremity polyarticular septic arthritis.Results Lesions involved in 4knees and 3hips.The injured hips kept flexion and abduction,with reduced or none locomotor activities.The injured knee joints presented joint swelling and increased local skin temperature,and the floating patella test was positive.All three patients were performed arthrotomy and treated with antibiotics,in which 2cases recovered well and one got pathological dislocation of bilateral hip.Conclusion The possibility of polyarticular septic arthritis should be considered when polyarticular swelling,limited activity and pain occurred.Arthrotomy or intraarticular puncture can prevent the missed diagnosis,misdiagnosis and inreversible injury of lesion to joints.