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骨髓炎治疗建议。

Recommendations for the treatment of osteomyelitis.

机构信息

Universidade de São Paulo, São Paulo, SP, Brazil.

Universidade de São Paulo, São Paulo, SP, Brazil.

出版信息

Braz J Infect Dis. 2014 Sep-Oct;18(5):526-34. doi: 10.1016/j.bjid.2013.12.005. Epub 2014 Apr 1.

Abstract

With the advances in surgical treatment, antibiotic therapy and the current resources for accurate diagnosis and differentiated approaches to each type of osteomyelitis, better results are being obtained in the treatment of this disease. After a careful literature review carried out by a multiprofessional team, some conclusions were made in order to guide medical approach to different types of osteomyelitis, aiming to obtain better clinical outcomes and reducing the social costs of this disease. Acute and chronic osteomyelitis are discussed, with presentation of the general epidemiological concepts and the commonly used classification systems. The main guidelines for the clinical, laboratory and imaging diagnosis of infections are discussed, as well as the guidelines for surgical and antimicrobial treatments, and the role of hyperbaric oxygen as adjuvant therapy.

摘要

随着外科治疗、抗生素治疗的进步,以及目前对准确诊断和针对每种类型骨髓炎的差异化方法的资源,这种疾病的治疗效果正在得到改善。多专业团队进行了仔细的文献回顾后,得出了一些结论,以便指导对不同类型骨髓炎的医疗方法,旨在获得更好的临床结果并降低这种疾病的社会成本。讨论了急性和慢性骨髓炎,介绍了一般流行病学概念和常用的分类系统。讨论了感染的临床、实验室和影像学诊断的主要指南,以及手术和抗菌治疗的指南,以及高压氧作为辅助治疗的作用。

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本文引用的文献

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Adult chronic osteomyelitis.成人慢性骨髓炎。
Orthopedics. 1984 Oct 1;7(10):1557-64. doi: 10.3928/0147-7447-19841001-07.
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Treatment algorithms for chronic osteomyelitis.慢性骨髓炎的治疗方案。
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Bone and joint infections in adults: a comprehensive classification proposal.成人骨与关节感染:一项综合分类建议
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Diagnosis and management of chronic infection.慢性感染的诊断与管理。
J Am Acad Orthop Surg. 2011;19 Suppl 1:S8-S19. doi: 10.5435/00124635-201102001-00003.
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Treating osteomyelitis: antibiotics and surgery.治疗骨髓炎:抗生素和手术。
Plast Reconstr Surg. 2011 Jan;127 Suppl 1:177S-187S. doi: 10.1097/PRS.0b013e3182001f0f.

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