假体周围感染的治疗

目的:探讨运用清创、抗生素骨水泥技术行假体感染后翻修术的可行性。方法:3例人工全髋,4例人工膝关节假体行彻底清创,脉冲枪冲洗,运用抗生素骨水泥作假体翻修的填充物。结果:感染性假体关节经清创、翻修后,伤口均愈合,3周后扶拐下床活动,术后1例10个月后感染复发,再进行2次清创翻修术后获得成功,术后Horris评分74分～83分,平均80分。结论:假体感染的治疗,清创是关键,抗生素骨水泥是防止再次感染的基础物质,注意感染性骨缺损的处理是功能恢复的保证。广谱、低毒、足量的血药浓度抗生素应用是必不可少的。

Treatment of Periprosthesis Infection

Objective: To explore the efficacy of the revision for periprosthesis infection by the techniques of debriment and antibiotic cement.Methods: A total of seven revision was carried out,including three total hip arthroplasty,four total knee arthroplasty,by completely debriment,flush with pulse gun and antibiotic cement.Results: A total of Seven patients was smoothly recovered by debriment and revision.They walked on crutches three weeks postoperatively.One of seven cases recurred ten months postoperatively and successful recovery was required after debriment and revision once more.They gained 80 scores averagely,ranging from 74～83 according to Horris.Conclusion: The debriment was a key measure in the treatment of periprosthesis infection and antibiotic cement was a basic substance for preventing infection recurrence.A special care must be taken to dealing with the infection bone deficiency.Broad-spectrum,low toxin and sufficient antibiotic concentration in the blood were necessary.