急性化脓性髋关节炎的关节镜治疗

Arthroscopy in the Management of Septic Coxitis

目的 :对成人急性化脓性髋关节炎关节镜下施行引流术后评价其疗效。对象及方法 :9例成人急性化脓性髋关节炎 ,根据理学检查和关节穿刺确诊后关节镜下急诊行边缘切除术及冲洗术 ,术后监测ESR (血沉 )及CRP(C 反应蛋白 )值观察其疗效。结果 :ESR恢复正常需 11 9d ,CRP恢复正常需 8 9d。术后随访 1年全部病例关节功能恢复正常 ,化验检查未发现感染征象。结论 :成人急性化脓性髋关节炎在关节镜下行关节边缘切除术及冲洗、引流术比关节切开引流术能减少术后并发症 ,是能取得良好疗效的有效术式。

Objective:To evaluate the usefulness of arthroscopy in the management of septic coxitis in adults.Methods:Nine patients ranging from 46 to 61 years of age were diagnozed to be septic coxitis by arthrocentesis and laboratory tests.Operative arthroscopy of the hip were performed on the patients under supine position.All patients had a follow-up period of more than 12 months by checking ESR and CRP,and by evaluating the function with Harris hip scoring system.Results:The laboratory abnormalities returned to normal level in average of 11.9 days after the surgery.Twelve months after the surgery,all patients showed normal hip function.Conclusion:Arthroscopic debridement and irrigation technique seem to have more advantages than open drainage in the management of septic coxitis minimizing the morbidity of the hip joint,while it obtains the same results as open technique.