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[1]彭兆祥,李瑾,林杰,等.全身應(yīng)用抗生素治療關(guān)節(jié)鏡下肩袖撕裂修復(fù)術(shù)后感染[J].中醫(yī)正骨,2019,31(02):52-55.
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全身應(yīng)用抗生素治療關(guān)節(jié)鏡下肩袖撕裂修復(fù)術(shù)后感染()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數(shù):
2019年02期
頁(yè)碼:
52-55
欄目:
臨床報(bào)道
出版日期:
2019-02-20

文章信息/Info

作者:
彭兆祥李瑾林杰丁少華
(寧波市醫(yī)療中心李惠利醫(yī)院,浙江 寧波 315041)
關(guān)鍵詞:
肩關(guān)節(jié) 肩袖撕裂 關(guān)節(jié)鏡檢查 手術(shù)后并發(fā)癥 感染 抗菌藥
摘要:
目的:探討全身應(yīng)用抗生素治療關(guān)節(jié)鏡下肩袖撕裂修復(fù)術(shù)后感染的臨床療效。方法:2010年1月至2016年12月收治7例關(guān)節(jié)鏡下肩袖撕裂修復(fù)術(shù)后感染患者。男3例,女4例; 年齡59~73歲,中位數(shù)68歲; 7例均出現(xiàn)肩部紅腫、疼痛癥狀,無(wú)發(fā)熱表現(xiàn); 5例肩關(guān)節(jié)周圍存在竇道并有滲液排出,2例肩關(guān)節(jié)周圍無(wú)竇道形成; 血象、血沉和C-反應(yīng)蛋白等實(shí)驗(yàn)室檢查均提示存在感染; MRI檢查均發(fā)現(xiàn)肩關(guān)節(jié)內(nèi)存在炎性改變; 4例合并糖尿病。關(guān)節(jié)鏡下肩袖撕裂修復(fù)術(shù)至出現(xiàn)感染癥狀的時(shí)間為11~45 d,中位數(shù)24 d。根據(jù)細(xì)菌培養(yǎng)結(jié)果和藥敏試驗(yàn)結(jié)果均給予全身應(yīng)用抗生素治療。治療結(jié)束后定期隨訪,檢測(cè)患者的血常規(guī)、血沉、C反應(yīng)蛋白,觀察竇道愈合、癥狀緩解及感染復(fù)發(fā)情況。以患肩竇道愈合,患肩局部紅腫、疼痛等癥狀完全消失,MRI檢查顯示肩關(guān)節(jié)滲液、多組織水腫信號(hào)消失、竇道組織愈合,外周血液中的白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞百分比、血沉和C-反應(yīng)蛋白恢復(fù)至正常范圍作為治愈標(biāo)準(zhǔn)。結(jié)果:7例患者治療時(shí)間8~10周,中位數(shù)9周; 均獲隨訪,隨訪時(shí)間6~38個(gè)月,中位數(shù)19個(gè)月。治療后患者竇道均順利愈合,肩部紅腫、疼痛癥狀均消失,MRI檢查顯示肩關(guān)節(jié)內(nèi)炎性改變消失,外周血液中的白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞百分比、血沉和C-反應(yīng)蛋白均恢復(fù)至正常范圍,均未出現(xiàn)感染復(fù)發(fā)。結(jié)論:全身應(yīng)用抗生素治療關(guān)節(jié)鏡下肩袖撕裂修復(fù)術(shù)后感染,臨床療效好、復(fù)發(fā)率低,值得臨床推廣應(yīng)用。

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備注/Memo

備注/Memo:
基金項(xiàng)目:國(guó)家自然科學(xué)基金青年科學(xué)基金項(xiàng)目(81401819); 寧波市自然科學(xué)基金項(xiàng)目(2018A610203) 通訊作者:李瑾 E-mail:[email protected](收稿日期:2018-10-14 本文編輯:時(shí)紅磊)
更新日期/Last Update: 2019-02-20