儿童化脓性膝关节炎的诊治(附11例报道)-东南大学学报医学版

儿童化脓性膝关节炎的诊治(附11例报道)

单位：1. 东南大学医学院附属徐州市中心医院骨关节科, 江苏徐州 221009;
2. 安徽省砀山县人民医院外五科, 安徽砀山 235300;
3. 徐州医学院附属连云港第一人民医院骨关节科, 江苏连云港 222022

分类号：R615

出版年·卷·期（页码）：2013·32·第五期（583-586）

摘要：

目的:探讨儿童化脓性膝关节炎的发病特点及诊疗方法。方法:对确诊为化脓性膝关节炎的11例儿童早期即静脉给予足量敏感抗生素治疗,同时行关节镜下清理术。11例患者平均随访24个月(12~36个月)。疗效评价指标为体温、血常规、血沉及C反应蛋白、连续3次关节液细菌培养、症状及功能改善评价HSS量表评分。结果:所有患儿均疼痛消失,关节活动度、体温、血常规、血沉及C反应蛋白恢复正常,连续3次关节液细菌培养阴性,随访平均24个月(12~36个月)未见复发;患儿术前HSS评分平均为(55.70±14.70)分,而术后随访平均为(89.96±7.25)分,手术前后比较差异有统计学意义 (P<0.01)。结论:儿童化脓性膝关节炎极易误诊,但只要诊断及时,采取正确的治疗手段,仍可以获得满意的临床疗效。

Objective: To investigate the pathogenetic characteristics as well as the diagnostic and therapeutic strategies for suppurative gonarthritis in children. Methods: Sufficient sensitive antibiotics were early intravenously ad-ministrated to 11 cases of children with suppurative gonarthritis, and arthroscopic debridement as well as postoperative lavage were performed. The children were followed up for 12 to 36 months(average of 24 months). The efficacy evaluation indicators were body temperature, blood count, erythrocyte sedimentation rate(ESR), C reactive protein(CRP), consecutive bacterial culture of synovial fluid for 3 times and the HSS rating scale conce-rning symptom-function improvement. Results: Pain of the children was significantly alleviated after treatment, mea-nwhile, the motion of joint, temperature, blood count, ESR and CRP were normalized, concurred with negative bacterial culture of synovial fluid for 3 times. Furthermore, there was no recurrence following 12-36 months with an average of 24 months. The average preoperative and postoperative HSS score of these children were 55.70±14.70 and 89.96±7.25, respectively, showing a significant difference(P<0.01). Conclusion: The suppurative gonarthritis in children is easily misdiagnosed. But satisfied therapy could be achieved through providing with timely and accurate diagnosis as well as correct treatment.

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