孙振辉;刘军;张宇;田孟强;孙云波;曹建刚;王磊;王沛;

• 1:天津市人民医院关节外科
• 2:天津医科大学总医院骨科

摘要(Abstract)：

[目的]分析Ⅱ期翻修治疗全膝置换(total knee arthrop lasty,TKA)术后感染化验指标动态变化,探讨感染有效控制的敏感指标。[方法]自2004年6月~2008年4月本院共收治TKA术后延迟感染患者20例,均采用抗生素骨水泥间隔假体植入Ⅱ期关节翻修治疗,每周检查血常规、红血球沉降率(ESR)、C反应蛋白,观察上述指标的动态变化,分析最为敏感的监测指标。[结果]C反应蛋白对感染控制最为敏感,其最大值出现在抗生素骨水泥隔体植入术后第1周,之后迅速减低,术后第2周和术前相比具有统计学差异(t=105.84,P<0.05)。ESR的最大平均值出现在隔体植入术前,平均为52.14 mm/1 h,之后缓慢下降,术后6周时基本接近正常范围。C反应蛋白和ESR在Ⅱ期翻修假体植入术后均升高,术后第2周C反应蛋白恢复正常,而ESR仍高于正常范围。白细胞计数治疗期间呈总体下降趋势,隔体植入术后6周时平均为4.1×109/L,但存在较多的波动。中性粒细胞各个时期比较无统计学差异(t检验,P>0.05)。[结论]Ⅱ期翻修治疗全膝置换术后感染控制指标中C反应蛋白最为敏感,治疗过程中一过性的升高无明显临床意义,ESR、白细胞计数相对不敏感,中性粒细胞百分比的动态变化无明显临床意义。

关键词(KeyWords)： 全膝关节置换;迟发感染;Ⅱ期翻修;C反应蛋白

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 孙振辉;刘军;张宇;田孟强;孙云波;曹建刚;王磊;王沛;

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参考文献(References)：

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