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[长期抗生素抑制治疗慢性骨髓炎]

[Management of chronic osteomyelitis by long-term antibiotic suppression].

作者信息

Kabore C, Wouters A, Frippiat F, Gillet P

机构信息

Université de Liège, Belgique.

Service de Chirurgie de l'Appareil Locomoteur, CHU de Liège, site Sart Tilman, Belgique.

出版信息

Rev Med Liege. 2017 Jul;72(7-8):363-368.

Abstract

Chronic osteomyelitis is a chronic inflammatory disease induced by bone infection. It may be limited to a single portion of bone or involve several areas such as marrow, cortical, periosteum and adjacent soft tissues. Being able to persist for weeks, months or even years, it remains a therapeutic challenge in spite of the important medical and surgical advances, with a prolonged and complex management given the nature of the surgical interventions and the antibiotherapies required. We report a case of chronic osteomyelitis treated by long-term suppressive antibiotic therapy, which may be a reasonable alternative to surgery in inoperable clinical situations, but taking into account the risks associated with it in terms of side effects and selection of resistant organisms, as well as the cost of treatment and the quality of life of the patient.

摘要

慢性骨髓炎是一种由骨感染引起的慢性炎症性疾病。它可能局限于骨的单个部位,也可能累及多个区域,如骨髓、皮质、骨膜及相邻软组织。尽管有重要的医学和外科进展,但它能够持续数周、数月甚至数年,鉴于手术干预的性质和所需的抗菌治疗,其治疗仍然是一项挑战,需要长期且复杂的管理。我们报告一例采用长期抑制性抗生素治疗的慢性骨髓炎病例,在无法进行手术的临床情况下,这可能是一种合理的手术替代方案,但要考虑到其在副作用、耐药菌选择、治疗成本以及患者生活质量方面的相关风险。

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