作　　者： ; ; ; ; ; ;

机构地区： 广州医科大学

出　　处： 《中国组织工程研究》 2018年第19期3044-3048,共5页

摘　　要： 背景:髋关节置换后感染对于年老体弱患者是灾难性的并发症,对于这类患者如何有效控制感染,保留一定的髋关节功能是一个难题。目的:探讨3D打印抗生素骨水泥股骨头占位器作为年老体弱患者髋关节置换后感染终极治疗的方法及疗效。方法:2014年1月至2016年12月采用3D打印抗生素骨水泥占位器作为终极治疗手段治疗4例年老体弱髋关节置换后感染患者,术后通过随访观察伤口愈合情况、髋部X射线检查、感染指标、髋关节功能Harris评分及髋部疼痛目测类比评分。结果与结论:(1)患者均获得随访,随访时间8-35个月;4例患者均于术后2周伤口愈合,无残留窦道;4例患者末次随访均无翻修,其中1例患者由于尿毒症诱发多器官功能衰竭于术后9个月死亡;(2)4例年老体弱患者经3D打印抗生素骨水泥股骨头占位器治疗后,感染得到有效控制,并保留了一定的髋关节功能;(3)目测类比疼痛评分由术前(8.0±1.5)分降到术后末次随访(2.0±1.4)分(P<0.05),Harris评分由术前(41.6±4.2)分提高到末次随访的(75.8±6.3)分(P<0.05);(4)提示对于年老体弱患者,采用3D打印抗生素骨水泥股骨头占位器能有效控制髋关节置换后感染,且保留一定的髋关节功能,亦可作为终极治疗方法。 BACKGROUND： Infection after hip arthroplasty was a catastrophic complication for the senile and infirm patients. It was difficult for such patients to effectively control infection and retain certain hip function.OBJECTIVE： To investigate the method and effect of three-dimensional（3 D） printed antibiotic bone cement spacer as the terminal treatment of infection after hip arthroplasty for the senile and infirm patients. METHODS： Between January 2014 and December 2016, the 3 D printed antibiotic bone cement spacer of femoral head was used as the terminal treatment for four senile and infirm patients with artificial joint infection after hip arthroplasty. The wound healing, hip X-ray examination, infection indicators, Harris score, Visual Analogue Scale score were assessed postoperatively. RESULTS AND CONCLUSION：（1） All patients were followed up for 8-35 months. In the four cases, wound healing without residual fistula was seen at postoperative 2 weeks. No revisions were performed at the last follow-up in four patients. Among them, one patient died of uremia-induced multiple organ failure at postoperative 9 months.（2） The infections were effectively controlled and the functions of hip were mostly retained after treatments by the 3 D printed antibiotic bone cement spacer of femoral head.（3） Visual Analogue Scale score decreased from preoperatively（8.0±1.5） points to the last follow-up（2.0±1.4） points（P 0.05）. Harris score increased from preoperatively（41.6±4.2） points to the last follow-up（75.8±6.3） points（P 0.05）.（4） These findings conclude that 3 D printed antibiotic bone cement spacer of femoral head can be used for effectively controlling hip infection and retaining most function of hip, for the senile and infirm patients with joint infection after hip arthroplasty. It can also be used as the ultimate treatment.

关 键 词： 关节成形术 置换 髋 感染 伤口愈合 组织工程 打印 髋关节置换 占位器

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