人工关节周围感染的多次冲洗与清创术：是面对必要之举还是仅仅在拖延不可避免之事？
Multiple Irrigation and Debridements for Periprosthetic Joint Infections: Facing a Necessity or Just Prolonging the Inevitable?
作者信息
Triantafyllopoulos Georgios, Poultsides Lazaros A, Zhang Wei, Sculco Peter K, Ma Yan, Sculco Thomas P
机构信息
Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
Epidemiology and Biostatistics Core, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
出版信息
J Arthroplasty. 2016 Jan;31(1):219-24. doi: 10.1016/j.arth.2015.06.051. Epub 2015 Jul 2.
Irrigation and debridement (I&D) may be a viable option in selected cases of periprosthetic joint infections (PJI). Our aim was to investigate the role of multiple I&Ds. Among 141 patients with PJI treated with I&D in our institution, 19 were subjected to additional procedures. Their clinical characteristics were retrospectively reviewed and compared to the remaining patients treated with a single I&D. The probability of treatment failure (removal of implants) was not significantly different among the two groups. The interval between serial I&Ds was a significant factor determining outcomes. Patients treated with multiple I&Ds had a significantly higher prevalence of peripheral vascular disease. The decision to proceed with repeat of I&D should be made with caution.
冲洗清创术（I&D）在某些假体周围关节感染（PJI）病例中可能是一种可行的选择。我们的目的是研究多次冲洗清创术的作用。在我们机构接受冲洗清创术治疗的141例PJI患者中，19例接受了额外的手术。回顾性分析了他们的临床特征，并与其余接受单次冲洗清创术的患者进行了比较。两组之间治疗失败（取出植入物）的概率没有显著差异。连续冲洗清创术之间的间隔是决定结果的一个重要因素。接受多次冲洗清创术治疗的患者外周血管疾病的患病率显著更高。决定重复进行冲洗清创术时应谨慎。
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