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[原发性关节感染]

[Native joint infections].

作者信息

Mühlhofer Heinrich M L, Feihl Susanne, Banke Ingo J, Suren Christian, Pohlig Florian, von Eisenhart-Rothe Rüdiger

机构信息

Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.

出版信息

Orthopade. 2020 Feb;49(2):191-200. doi: 10.1007/s00132-019-03852-0.

Abstract

Joint infections are a great challenge for the treating physicians. Infection of a native joint can result in the rapid destruction of the joint if treatment is inadequate or delayed and is associated with severe life-threatening diseases, such as sepsis. This article presents a detailed overview of the treatment of joint infections of native joints with a focus on the diagnostic approach and treatment decisions. Infections in native joints are caused either endogenously by hematogenic spreading or are caused by exogenous factors. A relevant proportion of joint infections in native joints occur in connection with iatrogenic measures, such as operations, synovial punctures and joint infiltrations. Fundamentally, acute infections represent an orthopedic surgical emergency, which is associated with the necessity for immediate operative measures. The best possible success can only be achieved by an interaction between early diagnosis, an adequate surgical approach and a tailor-made anti-infectious treatment. This is also the case with periprosthetic infections, which will be dealt with in detail in a second article.

摘要

关节感染对治疗医生来说是巨大的挑战。如果治疗不充分或延迟,原发性关节感染可导致关节迅速破坏,并与严重的危及生命的疾病(如败血症)相关。本文详细概述了原发性关节感染的治疗,重点是诊断方法和治疗决策。原发性关节感染要么由血源性传播内源性引起,要么由外源性因素引起。原发性关节感染中有相当一部分与医源性措施有关,如手术、滑膜穿刺和关节注射。从根本上说,急性感染是一种骨科手术急症,需要立即采取手术措施。只有通过早期诊断、适当的手术方法和量身定制的抗感染治疗之间的相互作用,才能取得最好的治疗效果。人工关节周围感染也是如此,这将在第二篇文章中详细讨论。

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