关节镜手术与保守治疗前交叉韧带重建后早期感染的效果比较

Comparison of the effects of arthroscopic operation and conservative treatment on early infection after anterior cruciate ligament reconstruction

目的分析关节镜手术与保守治疗前交叉韧带重建术后早期感染的效果差异。方法选择我院2012年1月至2018年3月收治的前交叉韧带重建术后早期感染患者42例作为研究对象,按治疗方式的不同将其分为对照组及研究组,各21例。对照组常规应用敏感抗生素及外敷药物、膝关节制动、冷敷等保守治疗,研究组在对照组基础上接受关节镜下关节清理及置管冲洗引流等手术治疗。比较两组的治疗效果。结果研究组平均手术次数为(1.95±0.65)次,移植物全部保留;两组全部治愈。治疗后1、2周,两组的WBC、ESR、CRP水平均降低,且研究组低于对照组(P<0.05)。治疗后3个月,两组的VAS评分均降低,SF-36、LKSS评分及ROM均升高,且研究组优于对照组(P<0.05)。研究组的抗生素使用时间及住院时间均短于对照组(P<0.05)。结论关节镜手术与保守治疗均能有效控制前交叉韧带重建术后早期感染,但手术治疗的总体效果突出。

Objective To analyze the different effects of arthroscopic operation and conservative treatment on early infection after anterior cruciate ligament reconstruction.Methods Forty-two patients with early infection after anterior cruciate ligament reconstruction treated in our hospital from January 2012 to March 2018 were selected as the research objects.According to the different treatment methods,the patients were divided into control group and study group,with 21 cases in each group.The control group received conservative treatment such as sensitive antibiotics and external application of drugs,knee joint immobilization,cold compress and others,while the study group received arthroscopic joint cleaning and catheter irrigation and drainage surgery on the basis of the control group.The therapeutic effects of the two groups were compared.Results The average number of surgeries in the study group was(1.95±0.65)times,and all the grafts were retained;both groups were cured.One and two weeks after treatment,the WBC,ESR,and CRP levels in the two groups decreased,and those in the study group were lower than the control group(P<0.05).Three months after treatment,the VAS score of both groups decreased,while SF-36,LKSS scores and ROM increased,and those in the study group were better than the control group(P<0.05).The antibiotic use time and hospital stay in the study group were shorter than those in the control group(P<0.05).Conclusion Both arthroscopic operation and conservative treatment can effectively control the early infection after anterior cruciate ligament reconstruction,but the overall effect of surgical treatment is outstanding.