全髋关节置换术后感染的治疗

目的 探讨全髋关节置换术后感染的临床治疗特点.方法 回顾性分析医院2006年1月-2011年1月进行全髋关节置换术术后感染的患者病历资料,对其临床治疗方法进行分析.结果 在本组中行保留假体清创术共6例,对失败的4例患者行二期翻修术,行二期翻修术5例,3例行一期翻修术；患者术后随访率100.0％,随访时间2～45个月,平均时间24.6个月,未见感染征象;12例患者均获一期愈合,术前、后髋关节Harris评分分别为50.6±6.42、68.2±12.16,差异有统计学意义；二期翻修术患者间隔时间为2.1～4.6个月,平均间隔时间2.2个月;采取二期翻修术患者随访未见感染征象.结论 全髋关节置换术术后感染临床治疗较复杂,针对术后感染患者应严格掌握适应证进行二期翻修术,临床效果较好.

Treatment of infections after total hip arthroplasty

OBJECTIVE To investigate the clinical treatment of the infections after the total hip arthroplasty.METHODS A retrospective analysis was performed for the clinical data of the patients with infections who underwent the total hip arthroplasty,the clinical treatment approaches were analyzed.RESULTS In this group totally 6 patients underwent retention of prosthesis and debridement,the 4 patients with failed surgery were treated with stage 2 revision surgery,there were 5 cases who underwent the stage 2 revision surgery and 3 cases who underwent stage 1 revision surgery;the follow-up rate was 100.0% after the surgery,the follow-up lasted for 2-45 months with the average time of 24.6 months,there had been no signs of infections;all the 12 patients were healed,the preoperative and postoperative Harris hip score was(50.6±6.42) and(68.2±12.16),respectively,the difference was statistically significant;the interval of the stage 2 revision surgery was 2.1-4.6 months,with the average interval of 2.2 months;there were no signs of infection in the patients underwent the stage 2 revision surgery.CONCLUSION The clinical treatment of the infections after total hip arthroplasty is complicated,it is of significant clinical effect to perform the stage 2 revision surgery by strictly grasping the indications.