人工全髋关节置换术后感染治疗现状

Treatment of surgical site infections after total hip arthroplasty

全球每年进行关节置换的数量超过100万人次，人工髋关节置换术后感染率约为0．3％-1．7％。对于治疗中主要争论点，作者建议：（1）手术方案应根据患者的个体情况具体分析；（2）自制型占位器可更好地控制感染；（3）每40g骨水泥中抗生素含量不应超过6g；（4）占位器体内搁置时间不应少于6周；（5）植入混有抗生素的同种异体骨可降低感染发生率；（6）术后状况好的患者可单独使用预防性抗生素治疗。

The number of surgical procedures for patients with total hip arthroplasty outweighs one million in the world. The infection rate after total hip arthroplasty was 0. 3%-1.7%. In this paper,the author makes the following reeommendings about the main treatment issues ： （ 1 ） operation plan should be made based on the individ- ual condition ; （ 2 ） home-made spacer can better control infections ; （ 3 ） each 40g of bone cement should not con- tain more than 6g of antibiotics ; （ 4 ） the period of spacer implantation should not be less than 6 weeks ; （ 5）using bone allografts with antibiotics can reduce the incidence of infections ; （ 6 ） prophylactic antibiotics could be used if patients have good postoperative outcome.