抗生素骨水泥临时占位器假体在慢性髋关节感染中应用的应用研究

The Applied Research of Antibiotic-Loaded Bone Cement Spacer Prosthesis in the Treatment of Chronic Hip Infection

目的评价抗生素骨水泥临时占位器假体在慢性髋关节感染中应用的有效性和安全性。方法选择我科2019年1月至2020年1月7例髋关节慢性感染患者,应用临时抗生素是骨水泥占位器植入待感染控制后二期再次行人工关节置换术的方法,观察患者初次手术前、术后1、3、7、14、30、60及90 d及二期术后30、60、90及180 d相关炎性指标变化趋势,观察患者占位器植入前后髋关节疼痛及髋关节功能及二期术后髋关节功能及疼痛改善情况,观察初次手术至第二次手术时间。结果所有患者均采用上述方法,安全完成手术。术后患者均取得随访,随访时间(9.14±1.95)个月,所有患者术后感染均得到有效控制,所有患者VAS评分及Harris评分初次手术前后及二期手术后较初次术后均明显改善,差异有统计学意义(P<0.05),持续监测患者术后相关炎性指标均逐步恢复正常,初次手术至第二次手术时间(4.44±0.91)个月。结论应用抗生素骨水泥临时占位器假体治疗髋关节慢性感染的方法临床疗效满意、安全。

Objective To evaluate safety and efficacy of antibiotic-loaded bone cement spacer prosthesis in the treatment of chronic hip infection.Methods From January 2019 to January 2020,7 patients with chronic hip infection underwent first surgery with temporary antibiotics spacer.When the infection was controlled,the second surgery of artificial joint replacement was performed.The inflammatory indexes were observed before or 1,3,7,14,30,60,90 day(s)after the first operation,and 30,60,90,180 days after the second surgery.The improvement of hip joint pain and hip joint function after 2 operations were observed separately,and the time from the first operation to the second operation was recorded.Results All patients were treated with the above mentioned operations,and the operation was completed safely.All patients were followed up for(9.14±1.95)months,and postoperative infection was effectively controlled in all patients.The VAS score and Harris score were significantly improved after the first and the second operation(P<0.05).The related inflammatory indexes were gradually restored to normal after operations.The time from the first operation to the second operation was(4.44±0.91)months.Conclusion The clinical effect of antibiotic-loaded bone cement spacer prosthesis in the treatment of chronic hip infection is satisfactory and safe.