Kang S-N, Sanghera T, Mangwani J, Paterson J M H, Ramachandran M
The Royal London Hospitals, Barts and The London NHS Trust, Whitechapel Road, Whitechapel, London E1 1BB, UK.
J Bone Joint Surg Br. 2009 Sep;91(9):1127-33. doi: 10.1302/0301-620X.91B9.22530.
We performed a systematic review of the optimal management of septic arthritis in children as recommended in the current English literature using MEDLINE, EMBASE, CINAHL, the Cochrane Library and reference lists of retrieved articles without date restrictions up to 31 January 2009. From 2236 citations, 227 relevant full-text articles were screened in detail; 154 papers fulfilled the inclusion criteria, from which conclusions were drawn on the management of infected joints in children. Our review showed that no single investigation, including joint aspiration, is sufficiently reliable to diagnose conclusively joint infection. The roles of aspiration, arthrotomy and arthroscopy in treatment are not clear cut, and the ideal duration of antibiotic therapy is not yet fully defined. These issues are discussed. Further large-scale, multi-centre studies are needed to delineate the optimal management of paediatric septic arthritis.
我们使用MEDLINE、EMBASE、CINAHL、Cochrane图书馆以及截至2009年1月31日检索到的文章的参考文献列表，对当前英文文献中推荐的儿童化脓性关节炎的最佳管理进行了系统评价，检索无日期限制。从2236条引用文献中，详细筛选了227篇相关全文文章；154篇论文符合纳入标准，据此得出关于儿童感染关节管理的结论。我们的综述表明，包括关节穿刺在内，没有任何一项单一检查足够可靠，能够最终确诊关节感染。穿刺、关节切开术和关节镜检查在治疗中的作用并不明确，抗生素治疗的理想疗程也尚未完全确定。对这些问题进行了讨论。需要进一步开展大规模、多中心研究来明确儿童化脓性关节炎的最佳管理方法。
