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局部麻醉下经皮穿刺灌洗与关节镜治疗原发性膝关节急性化脓性关节炎的疗效比较

Efficacy of Lavage by Tube under Local Anesthesia versus Arthroscopic Treatment of Acute Septic Arthritis of Native Knee.

作者信息

Oh Byung Hak, Heo Youn Moo, Yeo In Uk, Shin Woo Jin, Yoo Hyun Jin

机构信息

Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon 35365, Republic of Korea.

Myunggok Medical Research Institute, Konyang University, Daejeon 35365, Republic of Korea.

出版信息

Diagnostics (Basel). 2023 Jan 19;13(3):371. doi: 10.3390/diagnostics13030371.

Abstract

Although arthroscopic treatment is a minimally invasive surgery that effectively treats septic arthritis of the knee joint, it requires general or regional anesthesia. This study aimed to compare the clinical results of lavage after tube insertion versus arthroscopic treatment. Patients treated with arthroscopic treatment were included in group I ( = 76), while those treated with lavage by tube were included in group II ( = 34). We investigated the following in all patients: demographics, underlying disorders, initial serum white blood cell (WBC) count, C-reactive protein (CRP) level, synovial fluid WBC and polymorphonuclear cell counts, causative organism, initial Kellgren-Lawrence grade, lavage number, interventional delay, hospitalization days, CRP normalization time, and Western Ontario McMaster Universities Osteoarthritis index scores for clinical outcomes at 3 months postoperative. The mean interventional delay was significantly greater in group I (23.6 ± 15.6 h vs. 8.7 ± 9.3 h, < 0.001). The lavage by tube featured a significantly shorter interventional delay time than arthroscopy, while the CRP decrease rate did not differ between groups. Moreover, lavage by tube showed no significant differences in outcomes, including laboratory results and functional outcomes at 3 months postoperative.

摘要

尽管关节镜治疗是一种有效治疗膝关节化脓性关节炎的微创手术,但它需要全身麻醉或局部麻醉。本研究旨在比较置管冲洗与关节镜治疗的临床结果。接受关节镜治疗的患者纳入第一组(n = 76),而接受置管冲洗的患者纳入第二组(n = 34)。我们调查了所有患者的以下情况:人口统计学特征、基础疾病、初始血清白细胞(WBC)计数、C反应蛋白(CRP)水平、滑液白细胞和多形核细胞计数、病原体、初始Kellgren-Lawrence分级、冲洗次数、干预延迟时间、住院天数、CRP恢复正常时间以及术后3个月时用于评估临床结局的西安大略和麦克马斯特大学骨关节炎指数评分。第一组的平均干预延迟时间显著更长(23.6±15.6小时对8.7±9.3小时,P < 0.001)。置管冲洗的干预延迟时间明显短于关节镜检查,而两组之间CRP下降率没有差异。此外,置管冲洗在术后3个月的结果,包括实验室检查结果和功能结局方面没有显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/783d/9914019/6d15f4b5eb28/diagnostics-13-00371-g001.jpg

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