全髋关节置换术后假体感染诊治的研究进展

Progress in the Diagnosis and Treatment of Prosthesis Infection after Total Hip Arthroplasty

全髋关节置换术是髋部骨折常见的治疗手段,假体感染是全髋关节置换术后非常棘手的并发症,不但延长患者住院周期、增加临床治疗费用,还严重损害患者的身体健康,甚至对患者心理健康产生不良的影响。消除感染、逐步恢复关节活动度、提高患者的生活质量,是治疗全髋关节置换术术后假体感染的最终目的。本研究拟对全髋关节置换术术后假体感染的致病因素、致病菌、诊断和治疗措施等相关研究进行综述,梳理国内外关于临床确诊感染的各种标准,归纳总结临床常见的治疗假体感染的手术方法一期翻修和二期翻修的手术适应证、流程以及术后应用抗生素治疗的原则,重点对比两种手术方法各自的治疗优势和目前存在的争议,以期为治疗全髋关节置换术术后感染提供新思路。

Total hip arthroplasty(THA)is a common treatment method for hip fracture,and prosthesis infection is a very difficult complication after THA,which not only prolongs the patient's hospitalization period and increases the cost of clinical treatment,but also seriously damages the patient's physical health and even has a negative impact on the patient's mental health.Elimination of infection,gradual recovery of range of motion and improvement of life quality are the ultimate goals for the treatment of postoperative prosthesis infection.Relevant researches on the pathogenic factors,pathogens,diagnosis,and treatment measures of postoperative prosthesis infection after THA were reviewed in this article.Various domestic and foreign standards for the clinical diagnosis of prosthesis infection were discussed.The operation indications,operation process and postoperative antibiotic treatment principles for common clinical surgical methods for the treatment of prosthesis infection,namely single-stage revision and two-stage revision were summarized,and the respective advantages and the existing dispute of this two surgical methods were compared,in order to provide new way for the treatment of postoperative infection of THA.