利福平联合用药结合保留假体清创术治疗人工关节初期感染

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Abstract Objective To explore the effectiveness and safety of prothesis retention debridement and rifampicin in early low toxicity infection after arthroplasty.Methods We made a retrospective analysis on 12 patients with an initial low toxicity infection after arthroplasty in our hospital from February 2010 to February 2016.Among them，there were 4 male patients and 8 female patients.They aged from 65 to 75 with an average of 70.There were four patients with an infection after a total hip replacement and eight patients with an infection after a total knee replacement.The infection appears from the seventh day to one month after the replacement.Three patients with fistula and three patients with an acute infection underwent prothesis retention debridement，and they were treated with antibiotics for a week according to the results of drug sensitivity results.Then they took 300 mg of rifampicin and 500 mg of ciprofloxacin twice a day for six months.The other six patients were treated with rifampicin andotherantibioticsaccording to the results of drug sensitivity results.If the results were not good，they would have a prothesis retention debridement again and then have a rifampicin combination therapy.All patients were followedup，and follow-up visit period ranged from 6 to 27 months with an average of 24 months.Follow-up observation included：blood cell counts，blood sedimentation，C-reactive protein，liver function and imaging data，joint motion degree and joint function.The cure standard included the foll：There was no clinical infection；blood sedimentation was less than 20 mm/h，C-reactive protein was less than 5 mg/L or it significantly reduced and returned to normal；joint pain decreased or disappeared；range of joint motion was good.Results One patient had prosthesis failure in the therapeutic process.After accepting the joint revision，the patient was cured.The other 11 patients finished 6 months treatment.9 of them were cured successfully，but 2 of them failed.The overall cure rate was 81.8%.The infection was controlled.Conclusion Prothesis retention debridement and rifampicin in the treatment of early low toxicity infection after arthroplasty have a certain clinical efficacy and safety，which provides a certain reference value for the treatment of early low toxicity infection after arthroplasty.

Key words： rifampicin ciprofloxacin infection debridgment

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