| 努尔艾力江·玉山,张晓岗,吾湖孜·吾拉木,等.含大剂量复方倍他米松鸡尾酒注射液在一期翻修治疗假体周围感染中的应用及安全性研究.骨科,2024,15(4): 289-295. |
| 含大剂量复方倍他米松鸡尾酒注射液在一期翻修治疗假体周围感染中的应用及安全性研究 |
| Efficacy and Safety of Cocktail Containing High-dose Compound Betamethasone in Single-stage Revision for Treating Periprosthetic Joint Infection |
| 投稿时间：2024-04-23 |
| DOI：10.3969/j.issn.1674-8573.2024.04.001 |
| 中文关键词: 假体周围感染 复方倍他米松 一期翻修 镇痛 鸡尾酒 |
| 英文关键词: Periprosthetic joint infection Compound betamethasone Single-stage revision Analgesia Cocktail |
| 基金项目:国家自然科学基金（82002276）；新疆维吾尔自治区天山英才培养计划青年托举人才项目（2023TSYCQNTJ0018）；新疆医科大学第一附属医院暨第一临床医学院“青年科研起航”专项（2023YFY-QKMS-05） |
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| 中文摘要: |
| 目的 研究一期翻修治疗假体周围感染（PJI）中局部应用含大剂量复方倍他米松鸡尾酒注射液的疗效及安全性。方法 回顾性比较2015年1月至2020年12月于我院接受一期翻修治疗并在术中使用两种不同配方鸡尾酒注射液的170例PJI病人，其中A组72例，其鸡尾酒配方中含有复方倍他米松，B组98例，配方中不含复方倍他米松。比较两组术后的疼痛视觉模拟量表（VAS）评分、阿片类药物需求，以及术后恶心和呕吐（PONV）、感染复发、深静脉血栓形成（DVT）、肺栓塞（PE）和切口愈合不良等并发症的发生率。结果 术后12、24、48 h，A组的VAS评分均显著低于B组（P＜0.05），但两组术后72 h的VAS评分差异无统计学意义（P＞0.05）。B组关节液白细胞计数在术后24 h明显高于A组（P＜0.05），但在48 h后两组差异无统计学意义（P＞0.05）；B组的C反应蛋白（CRP）在术后48 h内明显高于A组（P＜0.05），但在术后72 h两组差异无统计学意义（P＞0.05）。A组的PONV发生率和阿片类药物使用率较B组显著较低（P＜0.05）。值得注意的是，两组之间感染复发率、DVT形成、PE和切口愈合不良等并发症情况比较，差异无统计学意义（P＞0.05）。结论 含有大剂量复方倍他米松的鸡尾酒注射液作为一期翻修术后早期的多模式局部浸润麻醉镇痛方案，可以有效减轻术后疼痛、减少阿片类药物的消耗以及PONV发生率，但对再感染和其他并发症没有影响。 |
| 英文摘要: |
| Objective To investigate the efficacy and safety of using high-dose compound betamethasone in cocktail during single-stage revision for periprosthetic joint infections (PJI). Methods Our retrospective analysis included 170 PJI patients who had undergone single-stage revisions for PJI from January 2015 to December 2020, including 72 patients receiving cocktail injection containing compound betamethasone (group A) and the rest 98 patients (group B). Postoperative visual analogue scale (VAS) scores, Opioid drug demand, postoperative nausea and vomiting (PONV), and the rate of reinfection, deep vein thrombosis (DVT), pulmonary embolism (PE), and poor wound healing were compared between the two groups. Results Group A had significantly lower VAS scores than group B within 12-48 h postoperatively (P＜0.05), and no significant differences were observed after 72 h (P＞0.05). The synovial fluid white blood cell (WBC) count in group B was significantly greater than that in group A within 24 h after surgery (P＜0.05), but there was no significant difference between the two groups after 48 h (P＞0.05). C reaction protein (CRP) in group B was significantly higher than that in group A within 48 h post-surgery (P＜0.05), but there was no significant difference between the two groups after 72 h (P＞0.05). The incidence of PONV and Opioid drug usage rate in group A were significantly lower (P＜0.05). Notably, there was no statistically significant difference in the reinfection rate, the incidence of postoperative DVT, PE, and poor wound healing between the two groups (P＞0.05). Conclusion Multimodal local infiltration analgesia with compound betamethasone as an early postoperative analgesia after a single-stage revision for PJI can reduce postoperative pain, opioid consumption, and PONV, but does not impact reinfections and complications. |
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