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万古霉素间隔器保留超过12个月患者的临床评估

CLINICAL EVALUATION OF PATIENTS WITH VANCOMYCIN SPACER RETAINED FOR MORE THAN 12 MONTHS.

作者信息

Kurebayashi Leonardo, de Melo Adauto Telino, Andrade-Silva Fernando Brandão, Kojima Kodi Edson, Silva Jorge Dos Santos

机构信息

Universidade de São Paulo, Faculdade de Medicina, Instituto de Ortopedia e Traumatologia, São Paulo, São Paulo, Brazil.

出版信息

Acta Ortop Bras. 2019 Jan-Feb;27(1):55-58. doi: 10.1590/1413-785220192701213649.

Abstract

OBJECTIVE

There is no consensus in the literature regarding the time taken to remove antibiotic spacers in the treatment of bone infections. The aim of this study is to evaluate the clinical results of patients with prolonged retention of the same.

METHODS

Patients selected were diagnosed with post-osteosynthesis infection and/or osteomyelitis and were submitted to treatment using an orthopedic cement spacer (polymethylmethacrylate) with vancomycin, retaining it for a period of more than 12 months. They were clinically evaluated to determine the presence of local or systemic infectious signs via hemogram, investigations of inflammatory markers, liver, renal and, with radiographic control.

RESULTS

Eighteen patients were included in the study. The mean retention time of the spacer was 30.4 months (15 - 61 months). No patient had clinical signs of local or systemic infectious relapse at the time of evaluation. Seven patients (39%) presented non-disabling pain in the operated limb. Seventeen patients (94%) presented a reduction in C-reactive protein values compared to the preoperative period. Radiographically, no migration, no spacer failure, or bone sequestration occurred.

CONCLUSION

In this retrospective case series, cement spacer retention with vancomycin for more than 12 months was associated with good clinical results, without relapse of the infectious condition. .

摘要

目的

关于治疗骨感染时取出抗生素骨水泥间隔物所需的时间,文献中尚无共识。本研究的目的是评估长期保留抗生素骨水泥间隔物的患者的临床结果。

方法

入选患者被诊断为骨内固定术后感染和/或骨髓炎,并接受含万古霉素的骨科骨水泥间隔物(聚甲基丙烯酸甲酯)治疗,保留时间超过12个月。通过血常规、炎症标志物检查、肝肾功能检查以及影像学检查对患者进行临床评估,以确定是否存在局部或全身感染迹象。

结果

18例患者纳入本研究。骨水泥间隔物的平均保留时间为30.4个月(15 - 61个月)。评估时,无患者出现局部或全身感染复发的临床迹象。7例患者(39%)手术肢体出现非致残性疼痛。与术前相比,17例患者(94%)的C反应蛋白值有所降低。影像学检查显示,未发生骨水泥间隔物移位、失效或骨坏死。

结论

在这个回顾性病例系列中,含万古霉素的骨水泥间隔物保留超过12个月与良好的临床结果相关,且感染情况无复发。

相似文献

本文引用的文献

1
Long-Term Outcomes of Permanent Cement Spacers in the Infected Foot.感染足部永久性骨水泥间隔物的长期疗效
J Foot Ankle Surg. 2017 Mar-Apr;56(2):287-290. doi: 10.1053/j.jfas.2016.10.022. Epub 2017 Jan 6.

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