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常见炎症标志物在全髋关节置换术感染长期筛查中的应用：我们的经验

Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our Experience.

作者信息

Falzarano Gabriele, Piscopo Antonio, Grubor Predrag, Rollo Giuseppe, Medici Antonio, Pipola Valerio, Bisaccia Michele, Caraffa Auro, Barron Elizabeth Mary, Nobile Francesco, Cioffi Raffaele, Meccariello Luigi

机构信息

Department of Orthopedics and Traumatology, Azienda Ospedaliera "Gaetano Rummo", Benevento, Italy.

Department of Orthopedics and Traumatology, Sacro Cuore di Gesù Fatebenefratelli Hospital, Benevento, Italy.

出版信息

Adv Orthop. 2017;2017:9679470. doi: 10.1155/2017/9679470. Epub 2017 Aug 23.

DOI:10.1155/2017/9679470
PMID:29138696
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5613705/
Abstract

Orthopedic implants have become essential components of modern medicine. The risk of infection of total hip arthroplasty (THA) is 1.5%-2%. Are the C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) good markers for THA infection screenings? From February 2009 to December 2012 at our Department of Orthopedics and Traumatology, 1248 patients were treated with THA. No prosthesis was cemented. All patients received antibiotic prophylaxis. All patients were discharged approximately 7.4 days after surgery with this clinical and radiographic follow-up program at 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. Blood samples to determine ESR, CRP, and PCT values were taken at 1 hour before surgery and 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. During follow-ups there were 22 cases of THA infections; according the Widmer classification, infections are hematogenous ones in 16 cases, late chronic ones in 5 cases, and early postoperative ones in 1 case. In all cases the three markers were considered positive; in 6 cases there were no radiological signs of septic loosening. ESR, CRP, and PCT proved to have a greater diagnostic accuracy than X-rays in predicting late chronic and early postoperative infections. These markers are valuable support for the surgeon in monitoring the prosthetic implant lifespan.

摘要

骨科植入物已成为现代医学的重要组成部分。全髋关节置换术（THA）的感染风险为1.5%-2%。C反应蛋白（CRP）、红细胞沉降率（ESR）和降钙素原（PCT）是THA感染筛查的良好标志物吗？2009年2月至2012年12月，我院骨伤科对1248例患者进行了THA治疗。未使用骨水泥固定假体。所有患者均接受抗生素预防。所有患者在术后约7.4天出院，并在术后15天以及1、3、6、12、24和36个月进行临床和影像学随访。在手术前1小时以及术后15天、1、3、6、12、24和36个月采集血样以测定ESR、CRP和PCT值。随访期间有22例THA感染病例；根据维德默分类，血源性感染16例，晚期慢性感染5例，术后早期感染1例。所有病例中这三种标志物均被视为阳性；6例无感染性松动的放射学迹象。ESR、CRP和PCT在预测晚期慢性感染和术后早期感染方面的诊断准确性高于X线。这些标志物对外科医生监测假体植入物的使用寿命具有重要的辅助作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/126e/5613705/1e3a654a1f5f/AORTH2017-9679470.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/126e/5613705/a3c83f7f9ba7/AORTH2017-9679470.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/126e/5613705/06fd2bce03df/AORTH2017-9679470.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/126e/5613705/1e3a654a1f5f/AORTH2017-9679470.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/126e/5613705/a3c83f7f9ba7/AORTH2017-9679470.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/126e/5613705/06fd2bce03df/AORTH2017-9679470.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/126e/5613705/1e3a654a1f5f/AORTH2017-9679470.003.jpg

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