本文選題：膝關(guān)節(jié) + 結(jié)核　； 參考：《新疆醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：探討一期病灶清除人工關(guān)節(jié)置換對(duì)成人晚期活動(dòng)性全膝關(guān)節(jié)結(jié)核可行性和療效。方法：回顧性分析2005年06月至2013年06月行一期病灶清除人工關(guān)節(jié)置換治療成人全膝關(guān)節(jié)結(jié)核22例,男9例(9個(gè)膝),女13例(13個(gè)膝)；年齡23～66歲,平均45.23歲�；颊呔邢リP(guān)節(jié)疼痛癥狀,患膝腫脹,主動(dòng)及被動(dòng)活動(dòng)疼痛均加重。膝關(guān)節(jié)不同程度伸屈功能受限,膝關(guān)節(jié)內(nèi)外側(cè)間隙壓痛均陽性,8例膝關(guān)節(jié)強(qiáng)直。紅細(xì)胞沉降率27-72mm/h,平均47.77mm/h。X線及CT檢查均示：關(guān)節(jié)間隙變窄或消失,骨質(zhì)不可逆性受損。膝關(guān)節(jié)結(jié)核診斷術(shù)后病理檢查證實(shí)。術(shù)前系統(tǒng)抗結(jié)核四聯(lián)強(qiáng)化治療2周-4周；術(shù)后繼續(xù)四聯(lián)強(qiáng)化治療2周,出院后三聯(lián)維持9～18月。結(jié)果：全部病例隨訪14～110月,平均30.46月。手術(shù)切口均一期愈合,1例術(shù)后2月結(jié)核復(fù)發(fā),1例術(shù)后6年假體無菌性松動(dòng),余病例隨訪期間X線檢查未見假體松動(dòng)及結(jié)核復(fù)發(fā)現(xiàn)象,紅細(xì)胞沉降率均在術(shù)后半年內(nèi)恢復(fù)正常。AKS膝關(guān)節(jié)評(píng)分由術(shù)前(25.59±5.07)分提高到末次隨訪時(shí)(85.09±4.23)分,差異有統(tǒng)計(jì)學(xué)意義。結(jié)論：在規(guī)范的抗結(jié)核化療下,一期病灶清除人工關(guān)節(jié)置換治療成人晚期活動(dòng)性全膝關(guān)節(jié)結(jié)核可達(dá)到控制感染,解除疼痛,安全、可行,術(shù)后遠(yuǎn)期復(fù)發(fā)率低。
[Abstract]:Objective: to investigate the feasibility and effect of one-stage debridement artificial joint replacement for late active total knee tuberculosis in adults.Methods: 22 adult patients with total knee joint tuberculosis were treated with one-stage debridement artificial joint replacement from June 2005 to June 2013. There were 9 males (9 knees) and 13 females (13 knees), aged 2366 years (mean 45.23 years).All patients had knee joint pain symptoms, knee swelling, active and passive pain aggravated.The extension and flexion function of the knee joint were limited to different degrees, and 8 cases of knee ankylosis were positive for tenderness in the internal and external space of the knee joint.The erythrocyte sedimentation rate was 27-72 mm / h, and the mean 47.77mm/h.X and CT showed that the joint space became narrow or disappeared, and the bone was irreversibly damaged.Diagnosis of knee tuberculosis postoperative pathological examination confirmed.The patients were treated with systemic anti-tuberculosis quadruple intensive therapy for 2 weeks to 4 weeks before operation, and for 2 weeks after operation, and for 9 to 18 months after discharge.Results: all patients were followed up from 14 to 11 months, with an average of 30.4 months.All the incisions were healed in one case with recurrence of tuberculosis at 2 months after operation and 1 case with aseptic loosening of prosthesis 6 years after operation. During the follow-up period of the remaining cases, there was no loosening of prosthesis and recurrence of tuberculosis.The erythrocyte sedimentation rate was increased from 25.59 鹵5.07 to 85.09 鹵4.23 at the last follow-up.Conclusion: under the standard anti-tuberculosis chemotherapy, one-stage debridement artificial joint replacement can control infection, relieve pain, safety and feasibility, and lower long-term recurrence rate in adult patients with active total knee tuberculosis.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 蔡道章,陳燕濤,戎利民;滑膜結(jié)核的關(guān)節(jié)鏡診斷和治療[J];中華結(jié)核和呼吸雜志;1998年05期

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本文編號(hào)：1770281