摘要
目的 设计制作兔人工股骨头置换后感染模型 ,探讨万古霉素 -聚甲基丙烯酸甲酯(VCM -PMMA)在感染预防中的作用。 方法 设计制作兔人工股骨头 ,对 48只日本大耳白兔行人工股骨头置换 ,随机分为 4组 :对照 1组以普通PMMA固定假体 ,VCM1组以VCM -PMMA固定假体 ,即刻接种 1× 10 6 CFU的耐甲氧西林表皮葡萄球菌 (MRSE)SAL65 164。对照 2组和VCM2组分别以普通PMMA和VCM -PMMA固定假体并接种 1× 10 8CFU的MRSE。检测X线片、细菌培养、组织学变化以及C -反应蛋白 (CRP)和血沉 (ESR)的变化。 结果 术后 4周 ,X线片示感染的关节间隙粗糙 ;对照 1组 75 .0 % ( 9/12 )、VCM1组 2 5 .0 % ( 3 /12 )、对照 2组 10 0 .0 % ( 12 /12 )、VCM2组 2 5 .0 %( 3 /12 )感染 ;血清CRP术后第 3天达高峰 ,ESR术后第 7天达高峰。 结论 兔人工股骨头置换后1× 10 8CFU的MRSESAL65 164即刻接种 ,可成功建立兔人工股骨头置换后感染模型 ;VCM
Objective To design and establish an animal model of hemiprosthetic hip joint infections and to study the role of Vancocin-loaded polymethylmethacrylate (VCM-PMMA) in prophylaxis of infections in rabbits. Methods Prostheses were successfully designed and made with stainless steel with its head of 7 mm or 8 mm in diameter after parameters of rabbits' femurs were obtained. Forty-eight rabbits were randomly divided into 4 groups, ie, control group 1, VCM group 1, control group 2 and VCM group 2. Then, the femoral heads were replaced with prostheses. Control group 1 was fixed with PMMA and VCM group 1 with VCM-PMMA. Immediately after the fixation, 1×10 6 CFU of Methicillin-resistant staphylococcus epidermidis (MRSE) was injected into the joints in the control group 1 and VCM group 1. Control group 2 and VCM group 2 were fixed with PMMA and VCM-PMMA respectively and injected with 1×10 8 CFU of MRSE. An observation was done on X-ray graphs, levels of serum CRP and ESR, pathological changes and bacteria cultures. Results After 1×10 6 CFU of MRSE was injected into the joints right after the revision surgery, 75.0% and 25.0% of hemiprosthetic hip joints were infected in the control group 1 and VCM group 1; 100.0% and 25.0% of hemiprosthetic hip joints were infected in the control group 2 and VCM group 2 with injection of 1×10 8 CFU. The levels of serum CRP elevated and reached their peaks at day 3, while that of ESR at day 7. If infected, the samples showed a higher quantity of inflammatory cells infiltration than that not infected. Conclusions An animal model of hemiprosthetic hip joint infections can be established successfully 4 weeks after MRSE of 1×10 8 CFU is injected into the joints immediately after replacement of the femoral heads with prostheses. VCM-PMMA is effective in preventing hemiprosthetic hip joints from infection.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2002年第11期667-670,共4页
Chinese Journal of Trauma
基金
第三军医大学科研基金资助项目 ( 41A1132 5 )
