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[初次及翻修髋关节置换术中的抗生素预防:证据是什么?]

[Antibiotic prophylaxis in primary and revision hip arthroplasty: what is the evidence?].

作者信息

Gradl G, Horn C, Postl L K L, Miethke T, Gollwitzer H

机构信息

Klinik für Orthopädie und Unfallchirurgie, Klinikum rechts der Isar, TU München, Ismaninger Strasse 22, 81675 München, Deutschland.

出版信息

Orthopade. 2011 Jun;40(6):520-7. doi: 10.1007/s00132-011-1755-0.

Abstract

Advances in the perioperative and postoperative management of total joint replacement have led to a steady decrease in the infection rate, which in the case of total hip replacement presently lies between 0.25 and 1%. Unfortunately there is disparity in current practice nationally and internationally, regarding duration, time of application and choice of antibiotics. Currently there are only Level 1a recommendations for primary hip arthroplasty, whereas, due to the heterogeneity and complexity of most revision cases as well as a lack of randomized controlled trials, antibiotic prophylaxis for hip revision arthroplasty is mostly based on the surgeon's preference. In this article the current literature is reviewed and scientifically sound data and recommendations are summarized.

摘要

全关节置换围手术期及术后管理的进展使感染率稳步下降,目前全髋关节置换的感染率在0.25%至1%之间。遗憾的是,在抗生素的使用时长、应用时间及选择方面,目前国内外的实际做法存在差异。目前对于初次髋关节置换仅有1a级推荐,而由于大多数翻修病例的异质性和复杂性以及缺乏随机对照试验,髋关节翻修置换术的抗生素预防大多基于外科医生的偏好。本文回顾了当前文献,并总结了科学可靠的数据和建议。

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