探讨清创术联合翻修术治疗关节置换术后急性感染的临床效果。

纳入本院2013年1月至2013年12月行关节置换术术后出现急性感染者62例，所有患者均进行手术治疗，包括清创及2期植入假体。观察患者手术治疗前后实验室检查、并发症以及髋关节功能等。

手术前病原菌共162株；术后患者红细胞沉降率、CRP水平均低于术前，差异具有统计学意义（t =13.131、14.437，P均= 0.000）；并发症包括骨溶解、假体松动、假体下沉、骨膜反应以及固定不稳，清创术联合翻修术后并发症发生率均显著低于术前，差异具有统计学意义（χ²= 25.282、14.523、6.305、11.521、12.071，P = 0.000、0.000、0.012、0.001、0.001）；术后随访2年发现，患者Harris评分优良率显著高于术前，差异有统计学意义（χ² = 75.581、P = 0.000）。

关节置换术后急性感染者使用一期清创联合二期翻修术效果显著，术后关节功能恢复好，并发症少。

To investigate the clinical effect of surgical treatment combined with debridement and prosthesis implantation for acute infection after joint replacement.

Total of 62 patients with acute infection after joint replacement hospitalized from January 2013 to December 2013 were selected and treated with debridement and prosthesis implant. Laboratory examination, complications and hip function of patients before and after surgical treatment were detected, respectively.

There were 162 strains of pathogenic bacteria before surgery. The levels of ESR and CRP after operation were all lower than those before operation, with significant differences (t =13.131, 14.437; P both = 0.000). The complications of patients were mainly osteolysis, prosthesis loosening, prosthesis subsidence, periosteal reaction and fixation instability, which incidence after debridement combined with prosthesis implantation were lower than those before operation, with significant differences (χ²= 25.282, 14.523, 6.305, 11.521, 12.071; P = 0.000, 0.000, 0.012, 0.001, 0.001). Two years’ follow-up were completed after surgery, and the rate of good Harris score after operation was higher than that before operation, with significant differences (χ² = 75.581, P = 0.000).

The surgical treatment combined with debridement and prosthesis implant in the second phase has significant effect in the treatment of patients with acute infection after joint replacement, with satisfied joint function recovery and little complications.