Hoyme U B, Tamimi H K, Eschenbach D A, Ramsey P G, Figge D C
Obstet Gynecol. 1984 Mar;63(3 Suppl):47S-53S.
The clinical and microbiologic features of five cases of osteomyelitis of the pubis after radical gynecologic and exenterative pelvic surgery are reported. Pain and tenderness over the pubic symphysis and difficulty with ambulation were common features. The interval between surgery and diagnosis ranged from eight to 17 weeks (average, 13.6 weeks). Erythrocyte sedimentation rate and alkaline phosphatase level were often abnormal, and x-rays, bone scan, and gallium scan were useful diagnostic tests. Osteomyelitis of the pubis contributed to an increased hospital stay of 5.6 weeks (mean) for patients undergoing radical vulvectomy and ten to 24 weeks for patients undergoing total pelvic exenteration. Intravenous antibiotic therapy followed by long-term oral administration may provide effective therapy, but the presence of necrotic bone requires surgical excision of necrotic and infected tissue.
报告了5例妇科根治性手术和盆腔廓清术后耻骨骨髓炎的临床及微生物学特征。耻骨联合处疼痛、压痛及行走困难是常见症状。手术至诊断的间隔时间为8至17周（平均13.6周）。红细胞沉降率和碱性磷酸酶水平常异常，X线、骨扫描和镓扫描是有用的诊断检查。耻骨骨髓炎使接受根治性外阴切除术的患者平均住院时间增加5.6周，使接受全盆腔廓清术的患者住院时间增加10至24周。静脉抗生素治疗后长期口服给药可能提供有效治疗，但存在坏死骨时需要手术切除坏死和感染组织。
