摘要
目的:通过对兔人工股骨头置换术后感染施行不同间隔时间的二期翻修术,初步选择二期翻修术时机,为临床治疗提供实验依据。方法:日本大耳白兔96只,行左侧人工股骨头置换术,术毕于关节腔内接种耐甲氧西林表皮葡萄球菌株(methicillin-resistantstaphylococcusepidermidis,MRSE)1×108CFU。术后4周清创,间隔不同时间二期再植新假体。实验动物根据间隔时间随机分为即刻再植组(R0组)、2周后再植组(R2组)、3周后再植组(R3组)、4周后再植组(R4组)、6周后再植组(R6组)和12周后再植组(R12组),每组16只,并于再植4周后处死。检测X射线片、细菌培养和血清C反应蛋白(CRP),血沉。结果:MRSE接种4周后所有关节均感染。二期再植和处死前各组感染率均下降,R4组、R6组和R12组感染控制满意,与R0组和R2组比较差异显著。清创前各组CRP和血沉显著升高。二期再植和处死前R4组、R6组和R12组的CRP明显下降。二期再植前仅R12组的血沉明显下降,处死前R4组和R6组的血沉才明显下降。结论:二期翻修术能有效控制人工关节置换术后感染,翻修时机以间隔4～6周为佳。
AIM:To select optimal timing for two stage revision arthroplasty for infected prosthetic femoral heads in rabbits at different intervals so as to provide experimental bases for its clinical treatment. METHODS:Methicillin resistant staphylococcus epidermidis(MRSE) of 1×108 CFU was intraarticularly injected immediately after the left femoral heads of 96 rabbits were replaced with prostheses.Debridement were performed four weeks later,and two stage revision arthroplasty with new prosthesis was employed to control infection at different intervals.According to the intervals between debridement and replantation,the rabbits were divided into six groups,i.e.,group R0,R2,R3,R4,R6 and R12,each group had 16 rabbits with corresponding intervals of 0, 2, 3, 4, 6 and 12 weeks.All the animals were sacrificed four weeks after replantation.X ray graphs,bacterial cultures and concentrations of serum C reactive protein(CRP) and erythrocyte sedimentation rate(ESR) were observed. RESULTS:All prosthetic hip joints were infected 4 weeks after MRSE,and the rate of infection decreased at replantation and before sacrificed,while the infection control decreased significantly for group R4,R6 and R12,as compared with that for group R0 and R2.The concentrations of CRP and ESR were significantly elevated at debridement.At replantation and sacrifice,concentration of CRP in group R4,R6 and R12 were significantly lowered than that at debridement,while for the concentration of ESR,it only lowered significantly in group R12 at replantation and in group R4 and R6 at sacrifice. CONCLUSION:Two stage revision arthroplasty can control infection of femoral head in rabbits efficiently,and the optimal timing is 4 to 6 weeks after debridement.
出处
《中国临床康复》
CSCD
2004年第17期3267-3269,i003,共4页
Chinese Journal of Clinical Rehabilitation
基金
解放军第三军医大学科研基金(41A11325)~~
