Ramaesh Rishikesan, Gaston Mark S, Simpson A Hamish R W
Department of Orthopaedic Surgery, University of Edinburgh, Edinburgh, United Kingdom.
Acta Orthop Belg. 2013 Jun;79(3):280-6.
The aim of this study was to examine the aetiology and response to treatment of a series of patients with pelvic osteomyelitis. Criteria for selection were multiple positive intra-operative cultures and/or a positive radiological diagnosis. Twenty patients met these criteria (age range: 21-78 years, mean = 46). Data was recorded on host status using the Cierny-Mader classification, neurological status, causative organisms; sensitivities were recorded and the treatment and its outcome. Pelvic osteomyelitis was frequently caused by unusual organisms; a high incidence (45%) of neurologically compromised patients was noted. There were important differences in infective organisms, treatment and outcome in the paraplegic and non-paraplegic population. A high mortality and a high incidence of squamous cell carcinoma was observed. Pelvic osteomyelitis should be managed differently to long bone osteomyelitis as far as the antibiotic therapy is concerned, with a greater need for broad spectrum antibiotics in pelvic osteomyelitis. The response to surgical resection was similar to long bone osteomyelitis with a high chance of success with marginal resection in type A hosts and with wide resection in type B hosts.
本研究的目的是检查一系列骨盆骨髓炎患者的病因及对治疗的反应。入选标准为术中多次培养阳性和/或放射学诊断阳性。20例患者符合这些标准（年龄范围：21 - 78岁，平均 = 46岁）。使用Cierny - Mader分类记录宿主状态、神经状态、致病微生物的数据；记录敏感性以及治疗及其结果。骨盆骨髓炎常由不常见的微生物引起；注意到神经功能受损患者的发生率较高（45%）。截瘫和非截瘫人群在感染微生物、治疗和结果方面存在重要差异。观察到高死亡率和高鳞状细胞癌发生率。就抗生素治疗而言，骨盆骨髓炎的管理应不同于长骨骨髓炎，骨盆骨髓炎更需要广谱抗生素。手术切除的反应与长骨骨髓炎相似，A型宿主行边缘切除、B型宿主行广泛切除成功的机会较高。
