[1]彭兆祥,李瑾,林杰,等.全身应用抗生素治疗关节镜下肩袖撕裂修复术后感染[J].中医正骨,2019,31(02):52-55.
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全身应用抗生素治疗关节镜下肩袖撕裂修复术后感染()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期数:
2019年02期
页码:
52-55
栏目:
临床报道
出版日期:
2019-02-20

文章信息/Info

作者:
彭兆祥; 李瑾; 林杰; 丁少华
(宁波市医疗中心李惠利医院,浙江 宁波 315041)
关键词:
肩关节;  肩袖撕裂;  关节镜检查;  手术后并发症;  感染;  抗菌药
摘要:
目的:探讨全身应用抗生素治疗关节镜下肩袖撕裂修复术后感染的临床疗效。方法:2010年1月至2016年12月收治7例关节镜下肩袖撕裂修复术后感染患者。男3例,女4例; 年龄59～73岁,中位数68岁; 7例均出现肩部红肿、疼痛症状,无发热表现; 5例肩关节周围存在窦道并有渗液排出,2例肩关节周围无窦道形成; 血象、血沉和C-反应蛋白等实验室检查均提示存在感染; MRI检查均发现肩关节内存在炎性改变; 4例合并糖尿病。关节镜下肩袖撕裂修复术至出现感染症状的时间为11～45 d,中位数24 d。根据细菌培养结果和药敏试验结果均给予全身应用抗生素治疗。治疗结束后定期随访,检测患者的血常规、血沉、C反应蛋白,观察窦道愈合、症状缓解及感染复发情况。以患肩窦道愈合,患肩局部红肿、疼痛等症状完全消失,MRI检查显示肩关节渗液、多组织水肿信号消失、窦道组织愈合,外周血液中的白细胞计数、中性粒细胞百分比、血沉和C-反应蛋白恢复至正常范围作为治愈标准。结果:7例患者治疗时间8～10周,中位数9周; 均获随访,随访时间6～38个月,中位数19个月。治疗后患者窦道均顺利愈合,肩部红肿、疼痛症状均消失,MRI检查显示肩关节内炎性改变消失,外周血液中的白细胞计数、中性粒细胞百分比、血沉和C-反应蛋白均恢复至正常范围,均未出现感染复发。结论:全身应用抗生素治疗关节镜下肩袖撕裂修复术后感染,临床疗效好、复发率低,值得临床推广应用。

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金青年科学基金项目(81401819); 宁波市自然科学基金项目(2018A610203) 通讯作者:李瑾 E-mail:lijindoctor@hotmail.com(收稿日期:2018-10-14 本文编辑:时红磊)
更新日期/Last Update: 2019-02-20