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[儿童骨髓炎]

[Osteomyelitis in children].

作者信息

Dietz H-G, Bachmeyr A, Joppich I

机构信息

Kinderchirurgische Klinik im Dr. v. Haunerschen Kinderspital der LMU München, Munich.

出版信息

Orthopade. 2004 Mar;33(3):287-96. doi: 10.1007/s00132-003-0605-0.

Abstract

Acute hematogenous osteomyelitis is a typical childhood illness, occurring predominantly in boys. The main symptom is inflammation but poor general condition also occurs occasionally. Elevation of CRP and sedimentation rate as well as leucocytosis are the most important laboratory findings. Conventional x-ray is mandatory, however scintigram and MRI are now specific in the early stage. Ultrasound can show abscess formation in the soft tissue. Treatment involves the immediate use of specifically targeted, intravenous antibiotics. Surgical intervention stands in second place. Immobilisation is only useful in the initial treatment of pain. Strict diagnostic and therapeutic management prevents complications, which would need reconstructive bone and soft tissue reconstruction, and is the key to a good primary prognosis.

摘要

急性血源性骨髓炎是一种典型的儿童疾病,主要发生在男孩身上。主要症状是炎症,但偶尔也会出现全身状况不佳。CRP、血沉升高以及白细胞增多是最重要的实验室检查结果。常规X线检查是必需的,不过骨闪烁显像和MRI在早期具有特异性。超声可显示软组织中的脓肿形成。治疗包括立即使用针对性的静脉抗生素。手术干预居其次。固定仅在疼痛的初始治疗中有用。严格的诊断和治疗管理可预防并发症,而这些并发症需要进行骨重建和软组织重建,这是获得良好初始预后的关键。

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