Диагностика и лечение перипротезной инфекции после эндопротезирования тазобедренного сустава (обзор литературы)

Диагностика и лечение перипротезной инфекции после эндопротезирования тазобедренного сустава (обзор литературы)

Автор: Дмитров И.А., Загородний Н.В., Оболенский В.Н., Леваль П.Ш., Захарян Н.Г., Апресян В.С., Панин М.А., Самкович Д.А., Алиев Р.Н., Григорян А.А.

Журнал: Вестник медицинского института "РЕАВИЗ": реабилитация, врач и здоровье @vestnik-reaviz

Рубрика: Клиническая медицина

Статья в выпуске: 6 (60), 2022 года.

Бесплатный доступ

Введение. Во всем мире частота выполняемых операций по поводу эндопротезирования тазобедренного сустава неуклонно растет и, хотя данная операция стала рутинной, вероятность развития послеоперационных осложнений достигает 4,3 % [1]. Наиболее опасным из них является инфекция в области эндопротеза и прилегающих к нему тканей, приводящая к снижению функции тазобедренного сустава и ухудшению качества жизни пациента, а в случаях отсутствия лечения - к генерализации инфекционного процесса. Своевременная диагностика и лечение инфекционного процесса и связанных с ним нарушений позволяет минимизировать неблагоприятные последствия перипротезной инфекции.Целью настоящего обзора является анализ современных методов диагностики и лечения перипротезной инфекции, возникшей после эндопротезирования тазобедренного сустава.Материалы и методы. Поиск тематической литературы осуществлялся по базам данных PubMed и Google Sholar.Результаты. Основные методы диагностики перипротезной инфекции включают: гистологическое и бактериологическое исследование биоптата, определение чувствительности к антибиотикам, анализ крови и синовиальной жидкости на содержание лейкоцитов, ИЛ-6, СРБ, ПЦР-диагностику инфекционных агентов. Лечение заключается в проведении ревизионного вмешательства и/или антибактериальной терапии.Заключение. Оптимальным методом диагностики перипротезной инфекции является бактериологическое исследование биоптатов, взятых интраоперационно. Предпочтительный метод лечения определяется тяжестью инфекционного поражения, степенью вовлечения прилегающих к эндопротезу тканей, коморбидным фоном пациента, природой инфекционного агента и включает повторное ревизионное вмешательство.

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Эндопротезирование, тазобедренный сустав, перипротезная инфекция, биопсия

Короткий адрес: https://sciup.org/143179604

IDR: 143179604   |   DOI: 10.20340/vmi-rvz.2022.6.CLIN.7

Список литературы Диагностика и лечение перипротезной инфекции после эндопротезирования тазобедренного сустава (обзор литературы)

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