Periprosthetic Joint Infection<\/p>\n
\u5173\u8282\u7f6e\u6362\u672f\u76f8\u5173\u611f\u67d3\u4e5f\u79f0\u4e3a\u5047\u4f53\u5468\u56f4\u611f\u67d3\uff08PJI\uff09\uff0c\u8fd9\u662f\u4e00\u79cd\u7f55\u89c1\u75be\u75c5\uff0c\u5728\u4e34\u5e8a\u4e0a\u6709\u522b\u4e8e\u81ea\u4f53\u9aa8\u611f\u67d3\u6216\u5173\u8282\u611f\u67d3\u3002PJI\u4e00\u65b9\u9762\u6d89\u53ca\u5fae\u751f\u7269\u4e4b\u95f4\u7684\u76f8\u4e92\u4f5c\u7528\uff0c\u53e6\u4e00\u65b9\u9762\u6d89\u53ca\u5047\u4f53\u4e0e\u5bbf\u4e3b\u514d\u75ab\u7cfb\u7edf\u4e4b\u95f4\u7684\u76f8\u4e92\u4f5c\u7528\u3002\u5c11\u91cf\u5fae\u751f\u7269\u5373\u53ef\u5f15\u8d77PJI\u3002\u7ec6\u83cc\uff08\u6709\u5c11\u6570\u75c5\u4f8b\u662f\u771f\u83cc\uff09\u53ef\u9644\u7740\u5728\u5047\u4f53\u8868\u9762\u5e76\u5f62\u6210\u751f\u7269\u819c\u3002\u8bb8\u591a\u6297\u5fae\u751f\u7269\u5242\u548c\u5bbf\u4e3b\u514d\u75ab\u7cfb\u7edf\u5f80\u5f80\u5bf9\u751f\u7269\u819c\u6ca1\u6709\u4f5c\u7528\uff08\u56fe1A\uff09\u3002\u81f4\u75c5\u5fae\u751f\u7269\u901a\u5e38\u662f\u5047\u4f53\u690d\u5165\u65f6\u79cd\u690d\u7684\u76ae\u80a4\u5fae\u751f\u7269\u7fa4\uff0c\u4f46\u4e5f\u53ef\u4ee5\u662f\u5047\u4f53\u690d\u5165\u540e\u8840\u884c\u64ad\u6563\u6216\u901a\u8fc7\u53d7\u635f\u5c40\u90e8\u7ec4\u7ec7\u64ad\u6563\u7684\u5fae\u751f\u7269\u3002<\/p>\n
\u56fe1. \u5173\u8282\u5047\u4f53\u5468\u56f4\u611f\u67d3\uff08PJI\uff09\u548c\u5e38\u89c1\u5173\u8282\u7f6e\u6362\u672f<\/p>\n
\u56feA\u663e\u793a\u819d\u5173\u8282\u7f6e\u6362\u672f\u540e\u611f\u67d3\u60a3\u8005\u5047\u4f53\u8868\u9762\u7684\u751f\u7269\u819c\u3002\u56feB\u663e\u793a\u5e38\u89c1\u5173\u8282\u7f6e\u6362\u672f\u3002\u56feC\u663e\u793a\u819d\u5173\u8282PJI\u5916\u89c2\uff0c\u8868\u73b0\u4e3a\u80bf\u80c0\u3001\u53d1\u7ea2\u3001\u5e95\u90e8\u5f00\u653e\u7684\u4f24\u53e3\u4f34\u6392\u6db2\u53ca\u7aa6\u9053\u3002\u5e76\u975e\u6bcf\u4f4d\u60a3\u8005\u90fd\u4f1a\u51fa\u73b0\u4e0a\u8ff0\u6240\u6709\u4e34\u5e8a\u8868\u73b0\u3002<\/p>\n
\u4e34\u5e8a\u8868\u73b0<\/p>\n
\u6700\u5e38\u89c1\u75c7\u72b6\u662f\u5173\u8282\u75bc\u75db\u3002\u67d0\u4e9b\u75c5\u4f8b\u53ef\u80fd\u6709\u611f\u67d3\u7684\u5c40\u90e8\u4f53\u5f81\uff08\u5982\u5173\u8282\u7ea2\u80bf\u53d1\u70ed\uff09\u3002\u60a3\u8005\u901a\u5e38\u5e76\u65e0\u53d1\u70ed\u3002\u6162\u6027\u611f\u67d3\u60a3\u8005\u53ef\u80fd\u53ea\u6709\u75bc\u75db\uff0c\u6709\u65f6\u4f34\u6709\u5047\u4f53\u677e\u52a8\u548c\u7aa6\u9053\uff08\u56fe1C\uff09\u3002\u5f62\u6210\u7aa6\u9053\u5bf9\u4e8ePJI\u5177\u6709\u8bca\u65ad\u610f\u4e49\uff0c\u4f46\u8bb8\u591a\u75c5\u4f8b\u5e76\u65e0\u7aa6\u9053\u3002\u67d0\u4e9b\u75c5\u4f8b\u53ef\u80fd\u96be\u4ee5\u9274\u522bPJI\u548c\u5173\u8282\u7f6e\u6362\u672f\u5931\u8d25\u7684\u975e\u611f\u67d3\u6027\u539f\u56e0\uff0c\u800c\u9274\u522b\u4e24\u8005\u53ef\u6307\u5bfc\u624b\u672f\u548c\u836f\u7269\u6cbb\u7597\u3002<\/p>\n
\u5fae\u751f\u7269\u5b66\u7279\u5f81<\/p>\n
\u6709\u8bb8\u591a\u7ec6\u83cc\uff08\u6709\u5c11\u6570\u75c5\u4f8b\u662f\u771f\u83cc\uff09\u53ef\u5bfc\u81f4PJI\u3002\u5728\u4e00\u9879\u7eb3\u51651651\u4f8b\u60a3\u8005\uff082067\u4f8b\u9acb\u5173\u8282\u6216\u819d\u5173\u8282PJI\uff09\u7684\u7814\u7a76\u4e2d\uff0c\u6700\u5e38\u89c1\u7684\u5fae\u751f\u7269\u662f\u51dd\u56fa\u9176\u9634\u6027\u8461\u8404\u7403\u83cc\uff08\u5c24\u5176\u662f\u8868\u76ae\u8461\u8404\u7403\u83cc\uff09\uff0c\u5176\u6b21\u662f\u91d1\u9ec4\u8272\u8461\u8404\u7403\u83cc\u3001\u94fe\u7403\u83cc\u3001\u80a0\u7403\u83cc\u3001\u4e19\u9178\u6746\u83cc\uff08cutibacterium\uff09\u548c\u80a0\u6746\u83cc\uff08\u88681\uff09 1\u3002\u8be5\u7814\u7a76\u5728\u4e00\u5bb6\u4e09\u7ea7\u8f6c\u8bca\u4e2d\u5fc3\u8fdb\u884c\uff0c\u7ed3\u679c\u53ef\u80fd\u4e0e\u5176\u4ed6\u673a\u6784\u6709\u6240\u4e0d\u540c\u300270%\u7684PJI\u662f\u7531\u5355\u4e00\u5fae\u751f\u7269\u5f15\u8d77\uff0c25%\u662f\u7531\u591a\u79cd\u5fae\u751f\u7269\u5f15\u8d77\u3002\u57f9\u517b\u7ed3\u679c\u9634\u6027\u7387\u56e0\u7814\u7a76\u800c\u5f02\uff0c\u8fd9\u53cd\u6620\u51fa\u8bca\u65ad\u7b56\u7565\u3001\u6297\u751f\u7d20\u9884\u5904\u7406\u548c\u57f9\u517b\u7ed3\u679c\u9633\u6027\u5b9a\u4e49\u7684\u5dee\u5f02\uff0c\u62a5\u544a\u7684\u57f9\u517b\u7ed3\u679c\u9634\u6027\u7387\u9ad8\u8fbe45%\u3002\u75e4\u75ae\u4e19\u9178\u6746\u83cc\uff08cutibacterium acnes\uff09\u5bfc\u81f4\u4e86\u7ea644%\u7684\u80a9\u5173\u8282PJI\u75c5\u4f8b2\u3002<\/p>\n
\u88681. \u9acb\u5173\u8282\u548c\u819d\u5173\u8282\u5047\u4f53\u5468\u56f4\u611f\u67d3\uff08PJI\uff09\u68c0\u51fa\u7684\u5fae\u751f\u7269*<\/p>\n
* \u6570\u636e\u6765\u81ea\u4e00\u5bb6\u4e09\u7ea7\u8f6c\u8bca\u4e2d\u5fc3\uff1b70%\u7684PJI\u4e3a\u5355\u4e00\u5fae\u751f\u7269\u5f15\u8d77\uff0c25%\u4e3a\u591a\u79cd\u5fae\u751f\u7269\u5f15\u8d771\u3002\u75c5\u539f\u4f53\u5206\u5e03\u53ef\u80fd\u56e0\u673a\u6784\u800c\u5f02\u3002<\/p>\n
\u6d41\u884c\u75c5\u5b66<\/p>\n
\u5728\u7f8e\u56fd\uff0c\u6700\u5e38\u5b9e\u65bd\u7684\u5173\u8282\u7f6e\u6362\u672f\u662f\u819d\u5173\u8282\u7f6e\u6362\u672f\uff0c\u5176\u6b21\u662f\u9acb\u5173\u8282\u7f6e\u6362\u672f\uff0c\u8f83\u5c11\u5b9e\u65bd\u7684\u662f\u80a9\u3001\u8098\u3001\u8155\u3001\u8e1d\u4ee5\u53ca\u638c\u6307\u5173\u8282\u548c\u6307\u95f4\u5173\u8282\u7f6e\u6362\u672f\uff08\u56fe1B\uff09\u3002\u7f8e\u56fd\u7684\u5168\u9acb\u5173\u8282\u548c\u5168\u819d\u5173\u8282\u7f6e\u6362\u672f\u6570\u91cf\u65e5\u76ca\u589e\u52a0\uff08\u9884\u8ba1\u5c06\u7ee7\u7eed\u589e\u52a0\uff093,4\uff0c\u9acb\u5173\u8282\u548c\u819d\u5173\u8282PJI\u6570\u91cf\u4e5f\u540c\u6b65\u589e\u52a0\uff08\u9884\u8ba1\u4e5f\u5c06\u7ee7\u7eed\u589e\u52a0\uff09\uff08\u56fe2\uff09\u3002<\/p>\n
\u56fe2. \u7f8e\u56fd\u9acb\u5173\u8282\u548c\u819d\u5173\u8282PJI\u6570\u91cf\u7684\u53d8\u5316<\/p>\n
\u6570\u636e\u6765\u81eaKurtz\u7b49\uff081990~2001\u5e74\uff093\u548cPremkumar\u7b49\uff082002~2017\u5e74\uff094\u7684\u8bba\u6587\uff0c\u5305\u62ec2018\u20142030\u5e74\u7684\u9884\u6d4b\u6570\u636e4\u3002<\/p>\n
2017\u5e74\uff0c\u7f8e\u56fd\u9acb\u5173\u8282\u548c\u819d\u5173\u8282PJI\u7684\u53d1\u75c5\u7387\u5206\u522b\u4e3a2.1%\u548c2.3% 4\uff0c\u97e9\u56fd\u53d1\u75c5\u7387\u76f8\u4f3c5\u3002\u7136\u800c\uff0c\u7531\u4e8e\u4eba\u7fa4\u3001\u5b9a\u4e49\u548c\u968f\u8bbf\u65f6\u95f4\u7684\u5dee\u5f02\uff0c\u4e0d\u540c\u7814\u7a76\u62a5\u544a\u7684\u53d1\u75c5\u7387\u6709\u6240\u4e0d\u540c6\u3002\u4f8b\u5982\uff0c\u5728\u7f8e\u56fd\u4e00\u5bb6\u673a\u6784\u5bf936,494\u4f8b\u521d\u6b21\u5168\u9acb\u5173\u8282\u7f6e\u6362\u672f\u8fdb\u884c\u7684\u7814\u7a76\u4e2d\uff0cPJI\u53d1\u75c5\u7387\u4e3a0.4% 7\u3002<\/p>\n
\u867d\u7136PJI\u98ce\u9669\u5728\u672f\u540e\u65e9\u671f\u6700\u9ad8\uff0c\u4f46\u53ea\u8981\u5173\u8282\u5b58\u5728\uff0c\u8be5\u98ce\u9669\u5c31\u6301\u7eed\u5b58\u5728\uff0c\u4e14\u6709\u76f8\u5f53\u4e00\u90e8\u5206\u611f\u67d3\u57281\u5e74\u540e\u8868\u73b0\u51fa\u75c7\u72b6\u3002\u5728\u52a0\u62ff\u5927\u4e00\u9879\u57fa\u4e8e\u4eba\u7fa4\u7684\u7814\u7a76\u548c\u65b0\u897f\u5170\u4e00\u9879\u767b\u8bb0\u7cfb\u7edf\u7814\u7a76\u4e2d\uff0c\u819d\u5173\u8282PJI\u53d1\u75c5\u7387\u5206\u522b\u4ece\u7b2c1\u5e74\u65f6\u76840.5%\u548c0.8%\u589e\u52a0\u81f3\u7b2c15\u5e74\u65f6\u76841.7%\u548c2.0% 8,9\u3002\u5728\u52a0\u62ff\u5927\u53e6\u4e00\u9879\u57fa\u4e8e\u4eba\u7fa4\u7684\u7814\u7a76\u4e2d\uff0c\u7b2c1\u5e74\u65f6\u9acb\u5173\u8282PJI\u53d1\u75c5\u7387\u4e3a0.5%\uff0c\u7b2c15\u5e74\u65f6\u4e3a1.4% 10\u3002\u867d\u7136\u65e9\u671f\u7814\u7a76\u62a5\u544a\u805a\u4e59\u70ef\u78e8\u635f\u662f\u5168\u819d\u5173\u8282\u7f6e\u6362\u672f\u5931\u8d25\u7684\u4e3b\u8981\u539f\u56e0\uff0c\u4f46\u6750\u6599\u7684\u6539\u8fdb\u5df2\u7ecf\u4f7fPJI\u6210\u4e3a\u4e3b\u8981\u539f\u56e08,11\u3002<\/p>\n
\u7ecf\u6d4e\u56e0\u7d20<\/p>\n
PJI\u6cbb\u7597\u6602\u8d35\u3001\u8017\u65f6\u4e14\u8017\u8d39\u8d44\u6e90\u3002\u9acb\u6b3e\u59d0\u548c\u819d\u5173\u8282PJI\u7684\u4f4f\u9662\u8d39\u7528\u5206\u522b\u7ea6\u4e3a\u6bcf\u6b2189,000\u7f8e\u5143\u548c116,000\u7f8e\u514312,13\u3002\u6839\u636e\u4f4f\u9662\u6570\u636e\uff0c\u5728\u5168\u9acb\u5173\u8282\u7f6e\u6362\u672f\u540e5\u5e74\u5185\uff0c\u56e0PJI\u4ea7\u751f\u7684\u7ffb\u4fee\u8d39\u7528\u662f\u56e0\u5176\u4ed6\u539f\u56e0\u4ea7\u751f\u7684\u7ffb\u4fee\u8d39\u7528\u76845\u500d\u4ee5\u4e0a14\u3002\u5728\u5047\u4f53\u7ec8\u8eab\u4f7f\u7528\u671f\u95f4\uff0c\u9acb\u5173\u8282PJI\u4ea7\u751f\u7684\u6700\u7ec8\u8d39\u7528\u7ea6\u4e3a39.1\u4e07\u7f8e\u514315\u3002\u622a\u81f32030\u5e74\uff0c\u7f8e\u56fd\u56e0\u9acb\u5173\u8282\u548c\u819d\u5173\u8282PJI\u4ea7\u751f\u7684\u4f4f\u9662\u8d39\u7528\u4f30\u8ba1\u5c06\u8fbe\u5230\u6bcf\u5e7418.5\u4ebf\u7f8e\u51434\u3002<\/p>\n
\u624b\u672f\u7b56\u7565\u5f71\u54cd\u8d39\u7528\u3002\u9acb\u5173\u8282\u6216\u819d\u5173\u8282PJI\u4e8c\u671f\u7ffb\u4fee\u672f\uff08\u53d6\u51fa\u5047\u4f53\u3001\u5168\u8eab\u5e94\u7528\u6297\u751f\u7d20\u3001\u4e4b\u540e\u690d\u5165\u65b0\u5047\u4f53\uff09\u8d39\u7528\u662f\u6e05\u521b\u4fdd\u7559\u5047\u4f53\u8054\u5408\u6297\u751f\u7d20\uff08\u4ee5\u4e0b\u7b80\u79f0DAIR\uff09\u8d39\u7528\u76842~4\u500d16\uff0c\u800cDAIR\u53c8\u662f\u65e0\u611f\u67d3\u60c5\u51b5\u4e0b\u66f4\u6362\u90e8\u5206\u5047\u4f53\u8d39\u7528\u7684\u7ea62\u500d17\u3002\u7f8e\u56fd\u8054\u90a6\u533b\u7597\u4fdd\u9669\uff08Medicare\uff09\u5bf9PJI\u6cbb\u7597\u8d39\u7528\u62a5\u9500\u4e0d\u8db3\uff0c\u6709\u5fc5\u8981\u57fa\u4e8e\u5176\u9ad8\u6602\u8d39\u7528\u66f4\u65b0\u62a5\u9500\u653f\u7b56\uff0c\u4ee5\u786e\u4fddPJI\u60a3\u8005\u6301\u7eed\u83b7\u5f97\u6cbb\u7597\u548c\u9ad8\u8d28\u91cf\u62a4\u7406\uff0c\u6709\u5176\u662f\u56e0\u4e3a\u62a5\u9500\u7f3a\u53e3\u53ef\u80fd\u4f1a\u964d\u4f4e\u533b\u7597\u8d44\u6e90\u4e0d\u8db3\u4eba\u7fa4\u7684\u533b\u7597\u53ef\u53ca\u6027\u3002<\/p>\n
\u5371\u9669\u56e0\u7d20<\/p>\n
\u76ee\u524d\u5df2\u786e\u5b9a\u4e86PJI\u7684\u591a\u79cd\u5371\u9669\u56e0\u7d20\uff08\u88682\uff09\uff0c\u5176\u4e2d\u53ea\u6709\u90e8\u5206\u56e0\u7d20\uff08\u5305\u62ec\u8d2b\u884018\u3001\u6ce8\u5c04\u6bd2\u54c119 \u3001\u8425\u517b\u4e0d\u826f18,20\u3001\u80a5\u80d67,18,20\u3001\u8840\u7cd6\u63a7\u5236\u4e0d\u4f73[\u5408\u5e76\u7cd6\u5c3f\u75c5]\u548c\u5438\u70df118,20\uff09\u6709\u53ef\u80fd\u6539\u53d89,10,18,20\u3002\u8bb8\u591a\u5916\u79d1\u533b\u5e08\u8bd5\u56fe\u5728\u5173\u8282\u7f6e\u6362\u672f\u524d\u89e3\u51b3\u8fd9\u4e9b\u56e0\u7d20\u3002\u6709\u4e00\u4e2a\u9884\u6d4b\u9acb\u5173\u8282PJI\u60a3\u8005\u6b7b\u4ea1\u98ce\u9669\u7684\u5728\u7ebf\u5de5\u5177\uff08https\/\/erikbulow.shinyapps.io\/prediction_model\/\uff0921\u3002<\/p>\n
\u88682. PJI\u7684\u5371\u9669\u56e0\u7d20<\/p>\n
* \u53ef\u5728\u672f\u524d\u6539\u5584\u8840\u7cd6\u63a7\u5236\u3002 <\/p>\n
\u5982\u679c\u5176\u4ed6\u90e8\u4f4d\u6709\u6d3b\u52a8\u6027\u611f\u67d3\uff08\u5982\u80ba\u708e\uff09\uff0c\u5219\u5e94\u63a8\u8fdf\u5173\u8282\u7f6e\u6362\u672f\u3002\u5168\u819d\u5173\u8282\u6216\u5168\u9acb\u5173\u8282\u7f6e\u6362\u672f\u524d3\u4e2a\u6708\u5185\uff0c\u60a3\u75c5\u5173\u8282\u66fe\u63a5\u53d7\u5173\u8282\u5185\u6ce8\u5c04\uff08\u5982\u7cd6\u76ae\u8d28\u6fc0\u7d20\u3001\u900f\u660e\u8d28\u9178\u6216\u9ebb\u9189\u836f\uff09\u662f\u53d1\u751fPJI\u7684\u5371\u9669\u56e0\u7d2022,23\u3002\u63a5\u53d7\u8fc7\u591a\u6b21\u5173\u8282\u7f6e\u6362\u672f\u4e14\u4e00\u4e2a\u5173\u8282\u53d1\u751fPJI\u7684\u60a3\u8005\uff0c\u5176\u4ed6\u5173\u8282\u53d1\u751f\u540c\u65f6\u6216\u5f02\u65f6\uff08\u53ef\u80fd\u5728\u6570\u5e74\u540e\uff09\u611f\u67d3\u7684\u98ce\u9669\u9ad8\u8fbe20%\u3002\u5728\u4e00\u9879\u7814\u7a76\u4e2d\uff0c\u5973\u6027\u548c\u8010\u7532\u6c27\u897f\u6797\u91d1\u9ec4\u8272\u8461\u8404\u7403\u83cc\uff08MRSA\uff09PJI\u60a3\u8005\u6bd4\u7537\u6027\u548c\u65e0MRSA\u7684\u60a3\u8005\u66f4\u6709\u53ef\u80fd\u5728\u5176\u4ed6\u5173\u8282\u53d1\u751f\u5f02\u65f6PJI\uff1b\u7c7b\u98ce\u6e7f\u5173\u8282\u708e\u60a3\u8005\u548c\u83cc\u8840\u75c7\u60a3\u8005\u5176\u4ed6\u5173\u8282\uff08\u540c\u65f6\u6216\u5f02\u65f6\uff09\u611f\u67d3\u7684\u53ef\u80fd\u6027\u4e5f\u589e\u52a0 24\u3002<\/p>\n
\u5373\u4f7f\u6839\u636e\u6559\u80b2\u6c34\u5e73\u548c\u5bb6\u5ead\u6536\u5165\u8fdb\u884c\u6821\u6b63\u540e\uff0c\u4e3b\u8981\u4ed8\u6b3e\u65b9\u662f\u7f8e\u56fd\u8054\u90a6\u533b\u7597\u4fdd\u9669\uff08Medicaid\uff09\u7684\u60a3\u8005\u53d1\u751fPJI\u7684\u98ce\u9669\u4ecd\u8f83\u9ad825\u3002\u636e\u62a5\u9053\uff0c\u8f83\u8d2b\u7a77\u60a3\u8005\u4ee5\u53caMedicare\u6216Medicaid\u4fdd\u9669\u60a3\u8005\u5728\u819d\u5173\u8282PJI\u540e\u63a5\u53d7\u819d\u4e0a\u622a\u80a2\uff0c\u4ee5\u53ca\u5728\u9acb\u5173\u8282PJI\u540e\u63a5\u53d7Girdlestone\u5207\u9664\u672f\u7684\u53d1\u751f\u7387\u8f83\u9ad826,27\u3002<\/p>\n
\u5728\u4e00\u9879\u7814\u7a76\u4e2d\uff0c\u9488\u5bf9\u793e\u4f1a\u7ecf\u6d4e\u56e0\u7d20\u8fdb\u884c\u6821\u6b63\u540e\uff0cPJI\u60a3\u8005\u4e00\u7ea7\u4eb2\u5c5e\u4ee5\u53ca\u4e00\u7ea7\u52a0\u4e8c\u7ea7\u4eb2\u5c5e\u53d1\u751fPJI\u7684\u98ce\u9669\u8f83\u9ad825\u3002\u53ef\u80fd\u7684\u9057\u4f20\u6613\u611f\u6027\u6709\u5f85\u8fdb\u4e00\u6b65\u7814\u7a76\u3002<\/p>\n
\u624b\u672f\u65f6\u95f4\u5ef6\u957f\u4f1a\u589e\u52a0PJI\u98ce\u9669\u3002\u5728\u4e00\u9879\u7814\u7a76\u4e2d\uff0c\u4e0e\u624b\u672f\u65f6\u95f4\u4e0d\u523060\u5206\u949f\u76f8\u6bd4\uff0c\u624b\u672f\u65f6\u95f4\u8d85\u8fc790\u5206\u949f\u4e0ePJI\u98ce\u9669\u589e\u52a01.6\u500d\u76f8\u517328\u3002<\/p>\n
\u9884\u9632<\/p>\n
\u9664\u51cf\u5c11\u53ef\u6539\u53d8\u7684\u5371\u9669\u56e0\u7d20\u5916\uff0c\u8fd8\u6709\u51e0\u79cd\u7b56\u7565\u6709\u52a9\u4e8e\u9884\u9632PJI\u3002\u5728\u624b\u672f\u91cf\u8f83\u5c11\u7684\u533b\u9662\u7531\u624b\u672f\u91cf\u8f83\u5c11\u7684\u5916\u79d1\u533b\u5e08\u5b9e\u65bd\u5173\u8282\u7f6e\u6362\u672f\u65f6\uff0c\u53d1\u751f\u5e76\u53d1\u75c7\u7684\u53ef\u80fd\u6027\u8f83\u592729\uff0c\u56e0\u6b64\u5e94\u8003\u8651\u5728\u4e13\u79d1\u4e2d\u5fc3\u8fdb\u884c\u6cbb\u7597\u3002\u5e94\u8003\u8651\u672f\u524d\u7b5b\u67e5\u91d1\u9ec4\u8272\u8461\u8404\u7403\u83cc\u643a\u5e26\u60c5\u51b5\uff0c\u5e76\u5bf9\u643a\u5e26\u8005\u8fdb\u884c\u53bb\u5b9a\u690d\uff0c\u6216\u8fdb\u884c\u666e\u904d\u53bb\u5b9a\u690d\u3002\u5728\u63a5\u53d7\u62e9\u671f\u5168\u819d\u5173\u8282\u7f6e\u6362\u672f\u6216\u5168\u9acb\u5173\u8282\u7f6e\u6362\u672f\u7684\u60a3\u8005\u4e2d\uff0c\u6bd4\u8f83\u624b\u672f\u90e8\u4f4d\u611f\u67d3\u548cPJI\u7684\u835f\u8403\u5206\u6790\u8868\u660e\uff0c\u672a\u8fdb\u884c\u53bb\u5b9a\u690d\u7684\u60c5\u51b5\u4e0b\uff0c\u4efb\u4f55\u611f\u67d3\u7684\u98ce\u9669\u5747\u589e\u52a030,31\uff0c\u91d1\u9ec4\u8272\u8461\u8404\u7403\u83cc30\u6216MRSA31 \u611f\u67d3\u7684\u98ce\u9669\u4e5f\u589e\u52a0\uff0c\u800c\u5728\u666e\u904d\u53bb\u5b9a\u690d\u4e0e\u57fa\u4e8e\u7b5b\u67e5\u7ed3\u679c\u7684\u53bb\u5b9a\u690d\u4e4b\u95f4\uff0c\u98ce\u9669\u5dee\u5f02\u5f88\u5c0f31\u3002\u63a5\u53d7\u62e9\u671f\u624b\u672f\u7684\u60a3\u8005\u81f3\u5c11\u5e94\u5728\u672f\u524d\u4e00\u665a\u7528\u6c2f\u5df1\u5b9a\u5e03\u6216\u80a5\u7682\u548c\u6c34\u6e05\u6d17\u76ae\u80a432\u3002<\/p>\n
\u5934\u5b62\u5511\u6797\u5e94\u5728\u624b\u672f\u5207\u5f00\u524d60\u5206\u949f\u5185\u7ed9\u836f\uff0c\u5e76\u5728\u6b62\u8840\u5e26\u5145\u6c14\u524d\u8f93\u5165\u3002\u4e0e\u5934\u5b62\u5511\u6797\u76f8\u6bd4\uff0c\u66ff\u4ee3\u836f\u7269\uff08\u5982\u4e07\u53e4\u9709\u7d20\u548c\u514b\u6797\u9709\u7d20\uff09\u4e0e\u8f83\u9ad8\u7684\u9acb\u5173\u8282\u3001\u819d\u5173\u8282\u548c\u80a9\u5173\u8282PJI\u98ce\u9669\u76f8\u51732,33-36\u3002\u867d\u7136\u4e00\u4e9b\u533b\u5e08\u5efa\u8bae\u5bf9\u8fc7\u654f\u8fdb\u884c\u8bc4\u4f30\uff08\u4f8b\u5982\u76ae\u8bd5\uff09\uff0c\u4f46\u62a5\u544a\u9752\u9709\u7d20\u8fc7\u654f\u7684\u60a3\u8005\u5927\u591a\u9002\u5408\u63a5\u53d7\u5934\u5b62\u5511\u6797\u6cbb\u7597\uff08\u5728\u65e0\u8fc7\u654f\u53cd\u5e94\u6216Stevens-Johnson\u7efc\u5408\u5f81\u75c5\u53f2\u7684\u60c5\u51b5\u4e0b\uff09 37,38\u3002\u5bf9\u4e8eMRSA\u5b9a\u690d\u7684\u60a3\u8005\uff0c\u4e00\u4e9b\u4e34\u5e8a\u533b\u5e08\u5efa\u8bae\u5728\u5934\u5b62\u5511\u6797\u57fa\u7840\u4e0a\u52a0\u7528\u4e07\u53e4\u9709\u7d20\u3002\u6bd4\u8f83\u5934\u5b62\u5511\u6797+\u4e07\u53e4\u9709\u7d20\u4e0e\u5934\u5b62\u5511\u6797\u5355\u836f\u9884\u9632\u7684\u4e00\u9879\u968f\u673a\u3001\u5bf9\u7167\u8bd5\u9a8c\u6b63\u5728\u8fdb\u884c\u4e2d\uff08\u5728\u6fb3\u5927\u5229\u4e9a\u65b0\u897f\u5170\u4e34\u5e8a\u8bd5\u9a8c\u6ce8\u518c\u7cfb\u7edf\u6ce8\u518c\u53f7\u4e3aACTRN12618000642280\uff09\u3002\u867d\u7136\u5728\u5386\u53f2\u4e0a\uff0c\u9884\u9632\u7528\u836f\u7684\u6301\u7eed\u65f6\u95f4\u5404\u5f02\uff0c\u4f46\u76ee\u524d\u7684\u5efa\u8bae\u662f\u5728\u5207\u53e3\u5173\u95ed\u65f6\u505c\u6b62\u9884\u9632\u7528\u836f32,39\u3002\u5bf9\u63a5\u53d7\u672f\u524d\u5355\u5242\u9884\u9632\u7684\u521d\u6b21\u5168\u819d\u5173\u8282\u6216\u5168\u9acb\u5173\u8282\u7f6e\u6362\u672f\u60a3\u8005\u4e0e\u63a5\u53d724\u5c0f\u65f6\u9884\u9632\u7684\u60a3\u8005\u6570\u636e\u8fdb\u884c\u6bd4\u8f83\u7684\u56de\u987e\u6027\u5206\u6790\u8868\u660e\uff0cPJI\u53d1\u751f\u7387\u65e0\u663e\u8457\u5dee\u5f0240\u3002\u5728\u5168\u819d\u5173\u8282\u7f6e\u6362\u672f\u60a3\u8005\u4e2d\u6bd4\u8f831\u5242\u548c3\u5242\u5934\u5b62\u5511\u6797\u7684\u968f\u673a\u4e34\u5e8a\u8bd5\u9a8c\u6b63\u5728\u8fdb\u884c\u4e2d\uff08\u5728ClinicalTrials.gov\u6ce8\u518c\u53f7\u4e3aNCT03283878\uff09\u3002\u9ad8\u5371\u60a3\u8005\u53ef\u80fd\u9700\u8981\u957f\u671f\u9884\u9632\uff0c\u4e3a\u63a2\u7d22\u8fd9\u4e00\u95ee\u9898\uff0c\u4e00\u9879\u968f\u673a\u8bd5\u9a8c\u6b63\u5728\u9ad8\u5371\u60a3\u8005\u4eba\u7fa4\u4e2d\u6bd4\u8f83\u5168\u9acb\u5173\u8282\u7f6e\u6362\u672f\u6216\u5168\u819d\u5173\u8282\u7f6e\u6362\u672f\u540e\u53e3\u670d\u6297\u751f\u7d20\u9884\u96327\u5929\u4e0e\u6807\u51c6\u6cbb\u7597\u5bf9PJI\u53d1\u751f\u7387\u7684\u5f71\u54cd\uff08NCT04297592\uff09\u3002<\/p>\n
\u624b\u672f\u65f6\u9700\u8981\u5bf9\u624b\u672f\u90e8\u4f4d\u8fdb\u884c\u9002\u5f53\u51c6\u5907\u3002\u6297\u5fae\u751f\u7269\u836f\u7269\u6d78\u6e0d\u7684\u5207\u53e3\u6577\u6599\uff08\u7531\u900f\u660e\u8584\u819c\u6784\u6210\u7684\u624b\u672f\u6577\u6599\uff0c\u65e8\u5728\u9884\u9632\u624b\u672f\u90e8\u4f4d\u611f\u67d3\uff09\u65e0\u654841\u3002\u5e94\u9650\u5236\u624b\u672f\u5ba4\u901a\u884c20\u3002\u5e94\u907f\u514d\u79ef\u6781\u6297\u51dd20\u3002\u6c28\u7532\u73af\u9178\u53ef\u964d\u4f4e\u9acb\u5173\u8282\u548c\u819d\u5173\u8282PJI\u53d1\u751f\u738742,43\u3002<\/p>\n
\u53ef\u8003\u8651\u5c06\u6297\u83cc\u836f\u7269\u5c40\u90e8\u9012\u9001\u81f3\u4f24\u53e3\u90e8\u4f4d\uff0c\u4f46\u9700\u8c28\u614e\u3002\u7f8e\u56fd\u9aa8\u79d1\u533b\u5e08\u5b66\u4f1a\uff08American Academy of Orthopaedic Surgeons\uff09\u5efa\u8bae\u5728\u5168\u9acb\u5173\u8282\u7f6e\u6362\u672f\u548c\u5168\u819d\u5173\u8282\u7f6e\u6362\u672f\u4e2d\u5e94\u7528\u7a00\u91ca\u805a\u7ef4\u916e\u7898\u704c\u6d17\uff0c\u4ee5\u964d\u4f4e\u611f\u67d3\u98ce\u966918\u3002\u7814\u7a76\u8868\u660e\uff0c\u4e0e\u5404\u5bf9\u7167\u7ec4\u76f8\u6bd4\uff0c\u7a00\u91ca\u805a\u7ef4\u916e\u7898\u704c\u6d17\u5bf9\u521d\u6b21\u624b\u672f\u6216\u7ffb\u4fee\u624b\u672f\u60a3\u8005\u65e0\u6548\u5e94\uff0c\u4f46\u5bf9\u76d0\u6c34\u5bf9\u7167\u7ec4\u7814\u7a76\u8fdb\u884c\u7684\u4e9a\u7ec4\u5206\u6790\u63d0\u793a\uff0c\u7a00\u91ca\u805a\u7ef4\u916e\u7898\u704c\u6d17\u5728\u9884\u9632PJI\u65b9\u9762\u6709\u654844\u3002\u5728\u53e6\u4e00\u9879\u7814\u7a76\u4e2d\uff0c\u5728\u521d\u6b21\u5168\u819d\u5173\u8282\u6216\u5168\u9acb\u5173\u8282\u7f6e\u6362\u672f\u524d\u63a5\u53d7\u8461\u8404\u7cd6\u9178\u6c2f\u5df1\u5b9a\u704c\u6d17\u7684\u60a3\u8005\u548c\u63a5\u53d7\u7a00\u91ca\u805a\u7ef4\u916e\u7898\u704c\u6d17\u7684\u60a3\u8005\u4e4b\u95f4\uff0cPJI\u53d1\u751f\u7387\u65e0\u663e\u8457\u5dee\u5f0245\u3002\u867d\u7136\u4e00\u4e9b\u5916\u79d1\u533b\u5e08\u5e94\u7528\u4e07\u53e4\u9709\u7d20\u7c89\u524246\uff0c\u4f46\u5176\u76ca\u5904\u5c1a\u672a\u5f97\u5230\u8bc1\u5b9e47\uff0c\u800c\u4e14\u6709\u6f5c\u5728\u5371\u5bb3\uff08\u4f8b\u5982\u672f\u540e\u4f24\u53e3\u65e0\u83cc\u6027\u5e76\u53d1\u75c7\uff09 47\u3002\u5bf9\u4e07\u53e4\u9709\u7d20\u7c89\u5242\u5f00\u5c55\u7684\u4e00\u9879\u591a\u4e2d\u5fc3\u3001\u968f\u673a\u3001\u5bf9\u7167\u8bd5\u9a8c\u6b63\u5728\u8fdb\u884c\u4e2d46\u3002<\/p>\n
\u8bca\u65ad<\/p>\n
PJI\u7684\u5b9a\u4e49\u4e0d\u65ad\u53d8\u5316\uff0c\u4ece2012\u5e74\u7f8e\u56fd\u611f\u67d3\u75c5\u5b66\u4f1a\uff08Infectious Diseases Society\uff09\u6307\u535748\u548c\u808c\u8089\u9aa8\u9abc\u611f\u67d3\u5b66\u4f1a\uff08Musculoskeletal Infection Society\uff09\u6807\u51c6\uff082011\uff0949 \u5230\u300a\u56fd\u9645\u9aa8\u79d1\u611f\u67d3\u5171\u8bc6\u300b\uff08International Consensus on Orthopedic Infections\uff09\u5b9a\u4e49\uff082018\uff0950\u3001Parvizi\u7b49\uff082018\uff0951\u63d0\u51fa\u7684\u5b9a\u4e49\u548c\u6b27\u6d32\u9aa8\u5173\u8282\u611f\u67d3\u5b66\u4f1a\uff08European Bone and Joint Infection Society\uff09\u5b9a\u4e49\uff082021\uff0952\u3002\u540e\u4e24\u79cd\u5b9a\u4e49\u7684\u6bd4\u8f83\u89c1\u88683\u548c\u8865\u5145\u9644\u5f55\u8868S1\uff0c\u8865\u5145\u9644\u5f55\u4e0e\u672c\u6587\u5168\u6587\u53ef\u5728NEJM.org\u83b7\u53d6\u3002\u4e86\u89e3\u8fd9\u4e9b\u4e0d\u65ad\u53d8\u5316\u7684\u5b9a\u4e49\u53ef\u80fd\u662f\u8bca\u65adPJI\u7684\u8d77\u70b9\u3002<\/p>\n
\u88683. \u9acb\u5173\u8282\u6216\u819d\u5173\u8282PJI\u7684\u8bca\u65ad\u6807\u51c6*<\/p>\n
* \u201c\u5355\u4e00\u201d\u8868\u793a\u53ea\u9700\u7b26\u5408\u5217\u51fa\u7684\u4e00\u9879\u6807\u51c6\u5373\u53ef\u786e\u8bca\u3002CFU\u8868\u793a\u83cc\u843d\u5f62\u6210\u5355\u4f4d\uff0cEBJIS\u8868\u793a\u6b27\u6d32\u9aa8\u5173\u8282\u611f\u67d3\u5b66\u4f1a\u3002<\/p>\n
\u2020 \u5728\u672f\u540e\u65e9\u671f\u6216\u5b58\u5728\u5176\u4ed6\u53ef\u80fd\u7684\u708e\u75c7\u539f\u56e0\uff08\u5305\u62ec\u91d1\u5c5e\u75c5\u3001\u5173\u8282\u79ef\u8840\u3001\u6676\u4f53\u5173\u8282\u75c5\u3001\u6d3b\u52a8\u6027\u708e\u75c7\u6027\u5173\u8282\u75be\u75c5[\u5982\u7c7b\u98ce\u6e7f\u5173\u8282\u708e]\u6216\u5047\u4f53\u5468\u56f4\u9aa8\u6298\uff09\u65f6\uff0c\u5e94\u8c28\u614e\u89e3\u8bfb\u3002\u8fd9\u4e9b\u6307\u6807\u4ec5\u5728\u6db2\u4f53\u6f84\u6e05\u3001\u672a\u4e0d\u8fdb\u884c\u704c\u6d17\u65f6\u6709\u6548\u3002\u5bb9\u79ef\u5e94\u5927\u4e8e250 \u03bcL\uff08\u7406\u60f3\u60c5\u51b5\u4e0b\u4e3a1 mL\uff09\uff0c\u7528EDTA\u7ba1\u6536\u96c6\uff0c\u5e76\u5728\u53ef\u80fd\u7684\u60c5\u51b5\u4e0b\uff0c\u4f7f\u7528\u81ea\u52a8\u5316\u6280\u672f\u57281\u5c0f\u65f6\u5185\u8fdb\u884c\u5206\u6790\u3002\u5bf9\u4e8e\u7c98\u6027\u6837\u672c\uff0c\u900f\u660e\u8d28\u9178\u9176\u9884\u5904\u7406\u63d0\u9ad8\u4e86\u81ea\u52a8\u5316\u6216\u5149\u5b66\u6280\u672f\u7684\u51c6\u786e\u6027\u3002\u5bf9\u8840\u6db2\u6837\u672c\u4f7f\u7528\u4ee5\u4e0b\u516c\u5f0f\uff1a\u6821\u6b63\u540e\u7684\u6ed1\u819c\u767d\u7ec6\u80de\u8ba1\u6570=\u89c2\u5bdf\u5230\u7684\u6ed1\u819c\u767d\u7ec6\u80de\u8ba1\u6570-\uff08\u8840\u6db2\u4e2d\u7684\u767d\u7ec6\u80de\u8ba1\u6570\u00f7\u8840\u6db2\u4e2d\u7684\u7ea2\u7ec6\u80de\u8ba1\u6570\u00d7\u6ed1\u6db2\u4e2d\u7684\u7ea2\u7ec6\u80de\u8ba1\u6570\uff09\u3002<\/p>\n
\u2021 \u8fd9\u4e00\u6807\u51c6\u5bf9\u4e8e\u6f5c\u5728\u7684\u5c40\u90e8\u7ec4\u7ec7\u4e0d\u826f\u53cd\u5e94\u3001\u8840\u80bf\u3001\u6025\u6027\u708e\u6027\u5173\u8282\u708e\u6216\u6676\u4f53\u5173\u8282\u75c5\u662f\u65e0\u6548\u7684\u3002<\/p>\n
\u00a7 B\u00e9mer\u7b49\u63d0\u51fa10\u4e2a\u9ad8\u500d\u89c6\u91ce\u4e2d23\u4e2a\u4e2d\u6027\u7c92\u7ec6\u80de\u7684\u9608\u503c53\u3002<\/p>\n
\u51c6\u786e\u7684\u8bca\u65ad\u5f88\u91cd\u8981\uff0c\u56e0\u4e3aPJI\u7684\u6cbb\u7597\u4e0e\u975e\u611f\u67d3\u6027\u5173\u8282\u8870\u7aed\u7684\u6cbb\u7597\u4e0d\u540c\uff0c\u5982\u679c\u5b58\u5728PJI\uff0c\u786e\u5b9a\u5fae\u751f\u7269\u75c5\u56e0\u6709\u52a9\u4e8e\u624b\u672f\u6cbb\u7597\u548c\u6297\u83cc\u836f\u7269\u7684\u9009\u62e9\u3002\u6025\u6027\u611f\u67d3\u6216\u5f15\u6d41\u7aa6\u6162\u6027\u611f\u67d3\u7684\u8bca\u65ad\u5f88\u7b80\u5355\u3002\u5728\u8fd9\u4e9b\u60c5\u51b5\u4e0b\uff0c\u68c0\u6d4b\u53ef\u80fd\u4ec5\u9650\u4e8e\u5fae\u751f\u7269\u5b66\u8bca\u65ad\u6240\u9700\u7684\u68c0\u6d4b\u3002\u5355\u662f\u5c40\u90e8\u5173\u8282\u75db\u5c31\u53ef\u80fd\u5bf9\u8bca\u65ad\u63d0\u51fa\u66f4\u591a\u6311\u6218\uff0c\u9700\u8981\u8fdb\u4e00\u6b65\u7684\u68c0\u67e5\u3002<\/p>\n
\u5305\u62ecC\u53cd\u5e94\u86cb\u767d\u6d4b\u5b9a\u5728\u5185\u7684\u8840\u6db2\u68c0\u67e5\uff0c\u4ee5\u53ca\u8bca\u65ad\u610f\u4e49\u8f83\u5c0f\u7684\u767d\u4ecb\u7d20-6\u3001\u7ea2\u7ec6\u80de\u6c89\u964d\u7387\u6216d-\u4e8c\u805a\u4f53\u8bc4\u4f30\u53ef\u80fd\u6709\u5e2e\u52a918,51,52\uff0c\u4f46\u8fd9\u4e9b\u68c0\u67e5\u7ed3\u679c\u4e0d\u80fd\u5355\u72ec\u7528\u4e8e\u8bca\u65ad\uff0c\u53ef\u80fd\u76f8\u4e92\u91cd\u590d\uff0c\u4e5f\u4e0d\u80fd\u63d0\u4f9b\u5fae\u751f\u7269\u5b66\u4fe1\u606f\u3002\u5f53\u8bca\u65ad\u4e0d\u660e\u786e\u65f6\uff0c\u88683\u6240\u793a\u7684\u8bca\u65ad\u68c0\u67e5\u548c\u76f8\u5173\u8bc4\u5206\u7cfb\u7edf\u53ef\u80fd\u6709\u5e2e\u52a9\u3002\u8840\u57f9\u517b\u7ea625%\u7684\u75c5\u4f8b\u5448\u9633\u6027\uff0c\u6700\u5e38\u89c1\u4e8e\u6025\u6027PJI\u75c5\u4f8b\uff0c\u4f46\u5206\u79bb\u51fa\u7684\u5fae\u751f\u7269\u5e76\u4e0d\u603b\u662f\u4e0e\u5173\u8282\u6807\u672c\u4e2d\u53d1\u73b0\u7684\u5fae\u751f\u7269\u76f8\u517354\u3002<\/p>\n
\u5173\u8282\u7a7f\u523a\u662f\u8bca\u65adPJI\u7684\u4e3b\u8981\u65b9\u6cd5\u3002\u5438\u53d6\u65f6\u907f\u5f00\u4e0a\u9762\u7684\u8702\u7a9d\u7ec7\u708e\u3002\u5bf9\u4e8e\u819d\u5173\u8282\u4ee5\u5916\u7684\u5176\u4ed6\u5173\u8282\uff0c\u5c24\u5176\u662f\u9acb\u5173\u8282\uff0c\u53ef\u80fd\u9700\u8981\u5f71\u50cf\u5b66\uff08\u6700\u597d\u662f\u8d85\u58f0\uff09\u5f15\u5bfc\u5438\u53d6\u3002\u5bf9\u4e8e\u5178\u578b\u5fae\u751f\u7269\uff0c\u5438\u53d6\u91cf\u81f3\u5c11\u4e3a3.5 mL 55\u3002\u5e94\u63d0\u4ea4\u6ed1\u6db2\u8fdb\u884c\u767d\u7ec6\u80de\u8ba1\u6570\u548c\u4e2d\u6027\u7c92\u7ec6\u80de\u767e\u5206\u6bd4\u8bc4\u4f30\u4ee5\u53ca\u57f9\u517b\u3002\u5b9e\u9a8c\u5ba4\u62a5\u544a\u7684\u6b63\u5e38\u6570\u503c\u548c\u81ea\u8eab\u5173\u8282\u7684\u5316\u8113\u6027\u5173\u8282\u708e\u6570\u503c\u4e0d\u9002\u7528\u4e8e\u767d\u7ec6\u80de\u8ba1\u6570\u548c\u4e2d\u6027\u7c92\u7ec6\u80de\u767e\u5206\u6bd4\u3002\u6211\u4eec\u4f7f\u7528\u4e86PJI\u7279\u5f02\u6027\u7684\u89e3\u91ca\u6807\u51c6\uff0c\u6807\u51c6\u56e0\u4f7f\u7528\u7684\u5b9a\u4e49\u4ee5\u53ca\u5173\u8282\u7f6e\u6362\u672f\u81f3\u53d1\u751f\u611f\u67d3\u7684\u95f4\u9694\u65f6\u95f4\u800c\u5f02\uff08\u88683\uff0918,51,52\u3002\u6211\u4eec\u53ef\u4ee5\u5728\u6ed1\u6db2\u4e2d\u68c0\u6d4b\u03b1-\u9632\u5fa1\u7d20\uff08Synovasure\uff0cZimmer Biomet\uff09\u3001C\u53cd\u5e94\u86cb\u767d\u3001\u767d\u7ec6\u80de\u916f\u9176\u548c\u9499\u536b\u86cb\u767d56\uff0c\u4e0e\u767d\u7ec6\u80de\u8ba1\u6570\u548c\u4e2d\u6027\u7c92\u7ec6\u80de\u767e\u5206\u6bd4\u76f8\u6bd4\uff0c\u6bcf\u79cd\u65b9\u6cd5\u63d0\u4f9b\u7684\u8bca\u65ad\u4fe1\u606f\u6709\u4e00\u5b9a\u5197\u4f59\u3002\u8fd9\u56db\u79cd\u68c0\u67e5\u901a\u5e38\u7528\u4e8e\u7591\u96be\u75c5\u4f8b57,58\u3002\u6ed1\u6db2\u5e94\u8fdb\u884c\u597d\u6c27\u548c\u538c\u6c27\u57f9\u517b\uff0c\u6700\u597d\u662f\u5728\u8840\u57f9\u517b\u74f6\u4e2d\uff0c\u538c\u6c27\u57f9\u517b14\u5929\u3002\u5982\u679c\u68c0\u6d4b\u5230\u4e34\u5e8a\u610f\u4e49\u4e0d\u786e\u5b9a\u7684\u5fae\u751f\u7269\uff0c\u5e94\u8003\u8651\u91cd\u590d\u62bd\u5438\uff0c\u6216\u8005\u5728\u672f\u4e2d\u57f9\u517b\u7684\u80cc\u666f\u4e0b\u89e3\u8bfb\u7ed3\u679c\uff08\u88683\uff09\u3002\u4e0d\u5efa\u8bae\u8fdb\u884c\u9769\u5170\u67d3\u8272\u3002\u5982\u679c\u672a\u53d1\u73b0\u5fae\u751f\u7269\uff0cPJI\u8bca\u65ad\u4ecd\u672a\u5f97\u5230\u8bc1\u5b9e\uff0c\u5e76\u4e14\u672a\u8ba1\u5212\u8fdb\u884c\u624b\u672f\uff0c\u5219\u53ef\u8003\u8651\u5173\u8282\u955c\u68c0\u67e5\u548c\u6d3b\u68c0\u3002<\/p>\n
X\u7ebf\u5e73\u7247\u7684\u654f\u611f\u5ea6\u548c\u7279\u5f02\u5ea6\u8f83\u4f4e\uff1b\u5047\u4f53\u5468\u56f4\u900f\u4eae\u7ebf\u3001\u9aa8\u6eb6\u89e3\u3001\u5047\u4f53\u79fb\u4f4d\u6216\u8fd9\u4e9b\u7ed3\u679c\u7684\u7ec4\u5408\u53ef\u80fd\u5728\u611f\u67d3\u6216\u65e0\u83cc\u6027\u677e\u52a8\u65f6\u51fa\u73b0\u3002\u767d\u7ec6\u80de\u95ea\u70c1\u663e\u50cf\uff08\u8868S1\uff09\u53ef\u80fd\u63d0\u4f9b\u6f5c\u5728PJI\u7684\u8bc1\u636e52\u3002\u5982\u679cPJI\u7684\u8bca\u65ad\u4e0d\u660e\u786e\uff0c\u5c24\u5176\u662f\u5728\u672a\u8ba1\u5212\u8fdb\u884c\u7ffb\u4fee\u624b\u672f\u7684\u60c5\u51b5\u4e0b\uff0c\u53ef\u8003\u8651\u8ba1\u7b97\u673a\u65ad\u5c42\u626b\u63cf\uff08CT\uff09\u621618F-\u6c1f\u8131\u6c27\u8461\u8404\u7cd6\u621618F-\u6c1f\u5316\u94a0\u6b63\u7535\u5b50\u53d1\u5c04\u65ad\u5c42\u626b\u63cf-CT 18\u3002\u78c1\u5171\u632f\u6210\u50cf\u5bf9\u4e0e\u975e\u94c1\u78c1\uff08\u5982\u949b\u548c\u94bd\uff09\u690d\u5165\u7269\u76f8\u5173\u7684\u8f6f\u7ec4\u7ec7\u5f02\u5e38\u63d0\u4f9b\u4e86\u826f\u597d\u7684\u5206\u8fa8\u7387\u3002\u7136\u800c\uff0c\u5c1a\u65e0\u5f71\u50cf\u5b66\u68c0\u67e5\u53ef\u7528\u4e8e\u786e\u5b9a\u81f4\u75c5\u75c5\u539f\u4f53\u3002<\/p>\n
\u5728\u624b\u672f\u65f6\uff0c\u5e94\u6536\u96c6\u7ec4\u7ec7\u8fdb\u884c\u7ec4\u7ec7\u75c5\u7406\u5b66\u8bc4\u4f30\uff08\u9664\u975e\u5df2\u7ecf\u786e\u5b9aPJI\u7684\u8bca\u65ad\uff09\uff0c\u5e76\u6536\u96c6\u591a\u4e2a\u7ec4\u7ec7\u6807\u672c\u8fdb\u884c\u6709\u6c27\u548c\u538c\u6c27\u57f9\u517b\uff08\u8003\u8651\u5230\u5355\u4e00\u57f9\u517b\u7684\u654f\u611f\u6027\u8f83\u5dee\uff0c\u4ee5\u53ca\u4e3a\u4e86\u533a\u5206\u6c61\u67d3\u7269\u548c\u75c5\u539f\u4f53\uff09\u3002\u4e0d\u5efa\u8bae\u8fdb\u884c\u62ed\u5b50\u57f9\u517b\u3001\u7aa6\u9053\u57f9\u517b\u548c\u7ec4\u7ec7\u9769\u5170\u67d3\u8272\u3002\u5f53\u6297\u751f\u7d20\u5728\u57f9\u517b\u524d\u81f3\u5c11\u505c\u75282\u5468\u65f6\uff0c\u57f9\u517b\u9633\u6027\u7387\u53ef\u80fd\u8f83\u9ad818\u3002\u7136\u800c\uff0c\u9884\u9632\u6027\u7684\u672f\u524d\u6297\u751f\u7d20\u6cbb\u7597\u4e0d\u4f1a\u964d\u4f4e\u57f9\u517b\u9633\u6027\u7387\uff0c\u56e0\u6b64\u5e94\u8be5\u4f7f\u752859\u3002\u901a\u8fc7\u5bf9\u6025\u6027\u708e\u75c7\u8fdb\u884c\u51b0\u51bb\u5207\u7247\u5206\u6790\uff0c\u53ef\u4ee5\u8fdb\u884c\u672f\u4e2d\u8bc4\u4f3060\u3002\u5e94\u53d6\u6837\u591a\u4e2a\u90e8\u4f4d\u548c\u7ec4\u7ec7\u7c7b\u578b\u8fdb\u884c\u57f9\u517b61\u3002\u5373\u4f7f\u672f\u524d\u6ed1\u6db2\u7684\u57f9\u517b\u7ed3\u679c\u4e3a\u9633\u6027\uff0c\u4e5f\u5e94\u6536\u96c6\u7ec4\u7ec7\u57f9\u517b\u7269\uff08\u4f8b\u5982\uff0c\u4ee5\u6392\u9664\u57fa\u7840\u6df7\u5408\u5fae\u751f\u7269PJI\u7684\u53ef\u80fd\u6027\uff0962\u3002\u7406\u60f3\u60c5\u51b5\u4e0b\uff0c\u5047\u4f53\u5468\u56f4\u7ec4\u7ec7\u6837\u672c\u5e94\u5728\u8840\u57f9\u517b\u74f6\u4e2d\u57f9\u517b63\uff0c\u538c\u6c27\u57f9\u517b\u7269\u5e94\u5b75\u80b214\u5929\u3002\u4f7f\u7528\u6807\u51c6\u5e73\u677f\u548c\u8089\u6c64\u57f9\u517b\u65f6\uff0c\u5e94\u57f9\u517b4\u4efd\u7ec4\u7ec7\u6807\u672c\uff1b\u4f7f\u7528\u8840\u57f9\u517b\u74f6\u65f6\uff0c\u5e94\u57f9\u517b3\u4efd\u7ec4\u7ec7\u6807\u672c64\u3002\u9664\u975e\u68c0\u6d4b\u51fa\u91d1\u9ec4\u8272\u8461\u8404\u7403\u83cc\u7b49\u660e\u786e\u7684\u75c5\u539f\u4f53\uff0c\u5426\u5219\u5355\u4e00\u9633\u6027\u57f9\u517b\u7269\u53ef\u80fd\u96be\u4ee5\u89e3\u8bfb\u3002\u5728\u4e24\u4e2a\u6216\u591a\u4e2a\u6807\u672c\u4e2d\u68c0\u51fa\u76f8\u540c\u7684\u5fae\u751f\u7269\u53ef\u786e\u7acb\u5fae\u751f\u7269\u5b66\u8bca\u65ad\u3002\u4e0d\u5e38\u89c4\u63a8\u8350\u771f\u83cc\u548c\u5206\u679d\u6746\u83cc\u57f9\u517b\uff0c\u4f46\u5728\u7279\u6b8a\u60c5\u51b5\u4e0b\u53ef\u8003\u865165\u3002<\/p>\n
\u5982\u679c\u53bb\u9664\u690d\u5165\u7269\u7ec4\u4ef6\uff0c\u5bf9\u690d\u5165\u7269\u8868\u9762\u8fdb\u884c\u68c0\u6d4b\u751f\u7269\u819c\u7684\u57f9\u517b\u53ef\u7528\u4e8e\u5fae\u751f\u7269\u5b66\u8bca\u65ad\u3002\u4e00\u79cd\u6280\u672f\u6d89\u53ca\u6da1\u65cb\u548c\u8d85\u58f0\u5904\u7406\u3002\u690d\u5165\u7269\u7684\u7ec4\u4ef6\u88ab\u653e\u7f6e\u5728\u4e00\u4e2a\u65e0\u83cc\u7684\u7f50\u5b50\u91cc\u3002\u52a0\u5165\u6eb6\u6db2\uff0c\u5e76\u5728\u8d85\u58f0\u6c34\u6d74\u4e2d\u5bf9\u5bb9\u5668\u8fdb\u884c\u6da1\u65cb\u548c\u8d85\u58f0\u5904\u7406\u3002\u6240\u5f97\u7684\u8d85\u58f0\u5904\u7406\u6db2\u8fdb\u884c\u9700\u6c27\u548c\u538c\u6c27\u534a\u5b9a\u91cf\u57f9\u517b66\u3002\u5fc5\u987b\u4f7f\u7528\u9002\u5f53\u7684\u4e34\u754c\u503c\uff0c\u56e0\u4e3a\u5c11\u91cf\u7684\u751f\u7269\u4f53\u53ef\u80fd\u4ee3\u8868\u6c61\u67d3\u7269\u3002\u7406\u60f3\u7684\u57f9\u517b\u654f\u611f\u5ea6\u662f\u901a\u8fc7\u7ec4\u7ec7\u57f9\u517b\u548c\u8d85\u58f0-\u6db2\u4f53\u57f9\u517b\u76f8\u7ed3\u5408\u5b9e\u73b0\u768467\u3002\u76ee\u524d\u6b63\u5728\u8bc4\u4f30\u65b0\u7684\u57fa\u4e8e\u8840\u6db2\u7684\u5bbf\u4e3b\u751f\u7269\u6807\u5fd7\u7269\uff0c\u5982presepsin 68\u3002\u7528\u4e8e\u5fae\u751f\u7269\u68c0\u6d4b\u548c\u7279\u5f81\u786e\u5b9a\u7684\u65b0\u8bca\u65ad\u65b9\u6cd5\u5305\u62ec\u5bf9\u6ed1\u6db269\u3001\u8d85\u58f0\u5904\u7406\u6db2\u6216\u5047\u4f53\u5468\u56f4\u7ec4\u7ec7\u8fdb\u884c\u768416S\u6838\u7cd6\u4f53RNA\u57fa\u56e0\u805a\u5408\u9176\u94fe\u53cd\u5e94\uff08PCR\uff09\u548cSanger\u6d4b\u5e8f\u6216\u4e8c\u4ee3\u6d4b\u5e8f\uff08\u5373\u9776\u5411\u5b8f\u57fa\u56e0\u7ec4\u6d4b\u5e8f[TMS]\uff09\u6216\u4e24\u8005\u540c\u65f6\u8fdb\u884c\uff0c\u4ee5\u53ca\u9730\u5f39\u67aa\u5b8f\u57fa\u56e0\u7ec4\u6d4b\u5e8f\uff08SMS\uff09\uff1bTMS\u548cSMS\u5bf9\u8d85\u58f0\u88c2\u89e3\u6db2\u7684\u8bc4\u4f30\u6548\u679c\u76f8\u4f3c70\u3002SMS\u4e0d\u4ec5\u53ef\u4ee5\u5bf9\u8d85\u58f0\u5904\u7406\u6db271\u8fdb\u884c\uff0c\u8fd8\u53ef\u4ee5\u5bf9\u6ed1\u6db272\u3001\u5047\u4f53\u5468\u56f4\u7ec4\u7ec773\u6216\u8840\u6d4674\u8fdb\u884c\u3002\u5728\u4e00\u9879\u5bf9\u6ed1\u6db2\u6216\u62ed\u5b50\u8fdb\u884c\u7684\u5546\u4e1aTMS\u68c0\u6d4b\u6cd5\uff08MicroGenDx\uff09\u7814\u7a76\u4e2d\uff0c\u8be5\u68c0\u6d4b\u6cd5\u7684\u654f\u611f\u5ea6\u548c\u7279\u5f02\u5ea6\u5747\u672a\u4f18\u4e8e\u57f9\u517b75\u3002\u5728\u53e6\u4e00\u9879\u7814\u7a76\u4e2d\uff0c\u5bf9\u6ed1\u6db2\u8fdb\u884c\u7684\u57fa\u4e8eTMS\u7684\u65b9\u6cd5\u663e\u793a\u51fa\u826f\u597d\u7684\u7279\u5f02\u5ea6\uff0c\u654f\u611f\u5ea6\u4e0e\u57f9\u517b\u76f8\u4f3c\uff1bTMS\u8054\u5408\u57f9\u517b\u7684\u654f\u611f\u5ea6\u9ad8\u4e8e\u5355\u7eaf\u57f9\u517b76\u3002\u6ed1\u6db2\u7684\u591a\u91cdPCR\u68c0\u6d4b\u8bd5\u5242\u76d2\uff08BioFire\uff09\u5df2\u83b7\u5f97\u7f8e\u56fd\u98df\u54c1\u836f\u54c1\u76d1\u7763\u7ba1\u7406\u5c40\u6279\u51c6\u3002\u4f46\u8bd5\u5242\u76d2\u7f3a\u4e4f\u4e00\u4e9b\u91cd\u8981\u7684PJI\u75c5\u539f\u4f53\u7684\uff0c\u5982\u8868\u76ae\u8461\u8404\u7403\u83cc77\u3002\u5728\u5148\u8fdb\u5206\u5b50\u8bca\u65ad\u5b66\u7684\u4e34\u5e8a\u4ef7\u503c\u901a\u8fc7\u9884\u5148\u8bca\u65ad\u68c0\u6d4b\u5f97\u5230\u8bc1\u660e\u4e4b\u524d\uff0c\u8fd9\u4e9b\u68c0\u6d4b\u5e94\u7528\u4e8e\u57f9\u517b\u7ed3\u679c\u4e3a\u9634\u6027\u7684\u7591\u4f3cPJI\u60a3\u800576,77\u3002<\/p>\n
\u6cbb\u7597<\/p>\n
PJI\u7684\u6cbb\u7597\u590d\u6742\u4e14\u6602\u8d35\uff0c\u5982\u679c\u53ef\u80fd\uff0c\u5e94\u5728\u7531\u4e13\u95e8\u534f\u4f5c\u56e2\u961f\uff08\u5373\u5728\u534f\u8c03\u8bca\u6240\u5de5\u4f5c\u7684\u9aa8\u79d1\u533b\u5e08\u548c\u611f\u67d3\u79d1\u533b\u5e08\uff09\u8fdb\u884c\u5927\u91cf\u4eba\u5de5\u5173\u8282\u624b\u672f\u7684\u4e13\u79d1\u4e2d\u5fc3\u63d0\u4f9b\u6cbb\u7597\uff0c\u8fd9\u4e0e\u764c\u75c7\u4e2d\u5fc3\u63d0\u4f9b\u7684\u6cbb\u7597\u6a21\u5f0f\u76f8\u4f3c\u3002\u6cbb\u7597\u7684\u76ee\u7684\u662f\u786e\u4fdd\u5173\u8282\u7684\u529f\u80fd\u548c\u65e0\u75db\uff0c\u6700\u7406\u60f3\u7684\u662f\u6cbb\u6108\u611f\u67d3\u3002\u5728\u5927\u591a\u6570\u60c5\u51b5\u4e0b\uff0c\u4ec5\u4f7f\u7528\u6297\u751f\u7d20\u6cbb\u7597\u800c\u4e0d\u8fdb\u884c\u624b\u672f\u5e72\u9884\u4f1a\u5931\u8d25\uff1b\u7ec6\u81f4\u7684\u624b\u672f\u6e05\u521b\u5f88\u91cd\u8981\u3002<\/p>\n
\u5bf9\u4e8e\u9acb\u5173\u8282\u3001\u819d\u5173\u8282\u7684\u6025\u6027PJI\uff0c\u9664\u975e\u5b58\u5728\u7aa6\u9053\u3001\u5047\u4f53\u677e\u52a8\u6216\u4f24\u53e3\u65e0\u6cd5\u95ed\u5408\uff0c\u53ef\u91c7\u7528DAIR 78\u3002\u6211\u4eec\u9700\u8981\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u6765\u786e\u5b9a\u665a\u671f\u6025\u6027PJI\u7684\u9002\u5f53\u624b\u672f\u7b56\u756579\uff0c\u5c24\u5176\u662f\u665a\u671f\u6025\u6027\u8461\u8404\u7403\u83cc\u6027PJI 80\u3002\u6162\u6027\u611f\u67d3\u9700\u8981\u5207\u9664\u6027\u5173\u8282\u6210\u5f62\u672f\uff0c\u53ef\u4ee5\u662f\u4e00\u671f\u7ffb\u4fee\uff08\u5728\u4e00\u6b21\u624b\u672f\u4e2d\u53d6\u51fa\u611f\u67d3\u7684\u5047\u4f53\u5e76\u91cd\u65b0\u690d\u5165\u65b0\u5047\u4f53\uff09\uff0c\u4e5f\u53ef\u4ee5\u662f\u4e8c\u671f\u7ffb\u4fee\u3002\u4e8c\u671f\u7ffb\u4fee\u4e2d\u4f7f\u7528\u7684\u6297\u751f\u7d20\u6d17\u8131\u805a\u7532\u57fa\u4e19\u70ef\u9178\u7532\u916f\u5173\u8282\u95f4\u9694\u57ab\u7247\uff08spacer\uff09\u6709\u52a9\u4e8e\u5728\u65e0\u5047\u4f53\u671f\u95f4\u4fdd\u6301\u529f\u80fd81\u3002\u867d\u7136\u4e8c\u671f\u7ffb\u4fee\u5728\u5386\u53f2\u4e0a\u4e00\u76f4\u662f\u7f8e\u56fd\u6162\u6027PJI\u7684\u4e3b\u8981\u6cbb\u7597\u65b9\u6cd5\uff0c\u4f46\u8d8a\u6765\u8d8a\u591a\u7684\u8bc1\u636e\u63d0\u793a\uff0c\u5728\u7ecf\u8fc7\u4ed4\u7ec6\u9009\u62e9\u7684\u60a3\u8005\u4e2d\uff0c\u4e00\u671f\u7ffb\u4fee\u53ef\u80fd\u662f\u53ef\u4ee5\u63a5\u53d7\u768482-86\u3002\u4e00\u9879\u6bd4\u8f83\u4e00\u671f\u548c\u4e8c\u671f\u9acb\u5173\u8282\u548c\u819d\u5173\u8282\u7ffb\u4fee\u672f\u7684\u968f\u673a\u8bd5\u9a8c\u6b63\u5728\u8fdb\u884c\u4e2d\uff08NCT02734134\uff09\u3002<\/p>\n
\u5982\u679c\u60a3\u8005\u4e0d\u9002\u5408\u624b\u672f\uff0c\u53ef\u5c1d\u8bd5\u4f7f\u7528\u6297\u83cc\u836f\u7269\u6291\u5236\u3002\u8fd9\u79cd\u65b9\u6cd5\u4e0d\u592a\u53ef\u80fd\u6cbb\u6108\u611f\u67d3\uff0c\u56e0\u6b64\u6297\u751f\u7d20\u6cbb\u7597\u901a\u5e38\u662f\u7ec8\u8eab\u7684\u3002\u5982\u679c\u672f\u540e\u9884\u671f\u5173\u8282\u529f\u80fd\u65e0\u6cd5\u63a5\u53d7\uff0c\u6216\u8005\u867d\u7136\u8fdb\u884c\u4e86\u624b\u672f\uff0c\u4f46\u611f\u67d3\u4ecd\u6301\u7eed\uff0c\u5219\u6709\u65f6\u53ef\u8003\u8651\u5173\u8282\u5207\u9664\u6210\u5f62\u672f\u5e76\u5efa\u7acb\u5047\u5173\u8282\uff08Girdlestone\u624b\u672f\uff09\uff0c\u6216\u8005\u5173\u8282\u878d\u5408\u672f\u6216\u622a\u80a2\u672f\uff08\u4f5c\u4e3a\u6cbb\u7597\u819d\u5173\u8282\u611f\u67d3\u7684\u6700\u540e\u624b\u6bb5\uff09\u3002<\/p>\n
\u6839\u636e\u6297\u83cc\u836f\u7269\u654f\u611f\u6027\u8bd5\u9a8c\u7ed3\u679c\u8fdb\u884c\u957f\u671f\u6297\u5fae\u751f\u7269\u6cbb\u7597\u53ef\u7528\u4e8e\u6cbb\u7597PJI\u3002\u9996\u9009\u6297\u751f\u7d20\u3001\u7ed9\u836f\u9014\u5f84\u548c\u6cbb\u7597\u6301\u7eed\u65f6\u95f4\u5c1a\u672a\u5b8c\u5168\u786e\u5b9a\u3002\u4e00\u9879\u968f\u673a\u3001\u5bf9\u7167\u8bd5\u9a8c\u5728\u63a5\u53d7DAIR\u6216\u4e00\u671f\u6216\u4e8c\u671f\u7ffb\u4fee\u6cbb\u7597\u7684PJI\u60a3\u8005\u4e2d\u6bd4\u8f83\u4e866\u5468\u548c12\u5468\u6297\u751f\u7d20\u6cbb\u7597\uff0c\u7ed3\u679c\u8868\u660e6\u5468\u7ec418%\u7684\u60a3\u8005\u548c12\u5468\u7ec49%\u7684\u60a3\u8005\u57282\u5e74\u5185\u53d1\u751f\u4e86\u6301\u7eed\u6027\u611f\u67d3\uff0c\u672a\u663e\u793a\u975e\u52a3\u6548\u602787\u3002\u7136\u800c\uff0c\u6b63\u5982\u4f5c\u8005\u6240\u6307\u51fa\u7684\uff0c\u201c6\u5468\u7ec4\u7684\u5927\u591a\u6570\u6cbb\u7597\u5931\u8d25\u53d1\u751f\u5728\u63a5\u53d7\u6e05\u521b\u672f\u5e76\u4fdd\u7559\u690d\u5165\u7269\u7684\u60a3\u8005\u4e2d\u3002\u201d\u8fd9\u4e9b\u7ed3\u679c\u4e0e\u5176\u4ed6\u7814\u7a76\u8005\u7684\u7ed3\u679c\u4e0d\u540c88,89\u3002\u6297\u751f\u7d20\u4ec5\u9759\u8109\u7ed9\u836f9\u5929\uff08\u4e2d\u4f4d\u6570\uff0987\u3002\u867d\u7136\u65e9\u671f\u8fc7\u6e21\u5230\u53e3\u670d\u6297\u751f\u7d20\u6cbb\u7597\u7684\u60c5\u51b5\u5728\u7f8e\u56fd\u5e76\u4e0d\u5e38\u89c1\uff0c\u4f46OVIVA\uff08\u9aa8\u548c\u5173\u8282\u611f\u67d3\u53e3\u670d\u4e0e\u9759\u8109\u6ce8\u5c04\u6297\u751f\u7d20\u6cbb\u7597\u7684\u6bd4\u8f83\uff0cOoral versus Intravenous Antibiotics for Bone and Joint Infection\uff09\u8bd5\u9a8c\u8868\u660e\uff0c\u5bf9\u4e8e\u590d\u6742\u7684\u9aa8\u79d1\u611f\u67d3\uff0c\u53e3\u670d\u6297\u751f\u7d20\u6cbb\u7597\u4e0d\u52a3\u4e8e\u9759\u8109\u7ed9\u836f\u6cbb\u759790\u3002\u81f3\u5c11\u5728\u7f8e\u56fd\uff0c\u8bb8\u591a\u9aa8\u79d1\u533b\u5e08\u548c\u611f\u67d3\u79d1\u533b\u5e08\u5efa\u8bae\u63a5\u53d7DAIR\u6cbb\u7597\u7684\u60a3\u8005\u63a5\u53d7\u6570\u6708\u6297\u751f\u7d20\u6cbb\u7597\u3002Shah\u7b49\u8bc1\u660e\uff0c\u5bf9\u4e8e\u63a5\u53d7DAIR\u6cbb\u7597\u7684\u819d\u5173\u8282PJI\uff0c\u4e0e\u5355\u72ec\u9759\u8109\u7ed9\u4e88\u6297\u751f\u7d20\u6cbb\u7597\u76f8\u6bd4\uff0c\u5ef6\u957f\u53e3\u670d\u6297\u751f\u7d20\u6cbb\u7597\u4e0e\u8f83\u9ad8\u7684\u65e0\u611f\u67d3\u751f\u5b58\u6982\u7387\u76f8\u517391\u3002\u5728\u5bf9\u8461\u8404\u7403\u83cc\u6027PJI\u5b9e\u65bd\u7684DAIR\u4e2d\uff0c\u5229\u798f\u5e73\u5e38\u4e0e\u53e6\u4e00\u79cd\u6d3b\u6027\u6297\u751f\u7d20\u8054\u7528\uff0c\u4f46\u652f\u6301\u8fd9\u4e00\u505a\u6cd5\u7684\u8bc1\u636e\u76f8\u4e92\u77db\u76fe79\u3002\u76ee\u524d\u6b63\u5728\u8bc4\u4f30\u5176\u4ed6\u5229\u798f\u9709\u7d20\uff08\u4f8b\u5982\u5229\u798f\u5e03\u6c40\uff09\u4f5c\u4e3a\u5229\u798f\u5e73\u7684\u66ff\u4ee3\u836f\u7269\u3002PJI\u7684\u6297\u5fae\u751f\u7269\u7597\u6cd5\u6b63\u5728\u5f00\u53d1\uff0c\u5173\u4e8e\u6cbb\u7597\u7b56\u7565\u7684\u8be6\u7ec6\u8ba8\u8bba\u8d85\u51fa\u4e86\u672c\u6587\u7684\u8303\u56f4\u3002<\/p>\n
\u7531\u4e8ePJI\u7684\u793e\u4f1a\u548c\u60c5\u7eea\u5f71\u54cd\uff08\u89c1\u4e0b\u6587\uff09\uff0c\u5e94\u8003\u8651\u8ba9\u5fc3\u7406\u5b66\u5bb6\u53c2\u4e0ePJI\u60a3\u8005\u7684\u6cbb\u759792\u3002<\/p>\n
\u7ed3\u5c40<\/p>\n
\u4e0e\u975e\u611f\u67d3\u6027\u5173\u8282\u6210\u5f62\u672f\u76f8\u6bd4\uff0cPJI\u4e0e\u4f4f\u9662\u65f6\u95f4\u5ef6\u957f\u3001\u4e0d\u592a\u7406\u60f3\u7684\u6210\u529f\u7387\u3001\u9ad8\u81f4\u6b8b\u7387\u3001\u751f\u6d3b\u8d28\u91cf\u4e0b\u964d\u548c\u9ad8\u6b7b\u4ea1\u7387\u76f8\u5173\u3002\u9acb\u5173\u8282\u6216\u819d\u5173\u8282PJI\u60a3\u8005\u7684\u5e73\u5747\u4f4f\u9662\u65f6\u95f4\u6bd4\u521d\u6b21\u5173\u8282\u7f6e\u6362\u672f\u60a3\u8005\u957f\uff08\u5168\u9acb\u5173\u8282\u7f6e\u6362\u672f\uff0c7.6\u5929vs. 3.3\u5929\uff1b\u5168\u819d\u5173\u8282\u7f6e\u6362\u672f\uff0c5.3\u5929vs. 3.0\u5929\uff0912,13\u3002\u4e00\u7bc7\u5305\u542b29\u9879\u7814\u7a76\uff082000~2020\u5e74\u671f\u95f4\u62a5\u544a\uff09\u7684\u7efc\u8ff0\u8868\u660e\uff0c\u4e00\u671f\u548c\u4e8c\u671f\u5168\u819d\u5173\u8282\u7f6e\u6362\u672f\u540e\u7684\u5e73\u5747\u611f\u67d3\u6839\u9664\u7387\u5206\u522b\u4e3a87%\u548c83% 84\u3002\u7136\u800c\uff0c\u4e8c\u671f\u7ffb\u4fee\u7684\u603b\u4f53\u6210\u529f\u7387\u4f4e\u4e8e50% 93,94\uff0c\u5176\u4e2d\u9acb\u5173\u8282\u7ffb\u4fee\u7684\u5b8c\u6210\u7387\u4e3a43%\uff0c\u819d\u5173\u8282\u7ffb\u4fee\u7684\u5b8c\u6210\u7387\u4e3a11%~48% 93,95\u3002\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u9009\u62e9\u504f\u501a\u53ef\u80fd\u5f71\u54cd\u4e86\u8fd9\u4e9b\u7814\u7a76\u4e2d\u62a5\u544a\u7684\u7ed3\u5c40\u3002\u5728\u5bf9\u6fb3\u5927\u5229\u4e9a\u548c\u65b0\u897f\u5170\u7684\u9acb\u5173\u8282\u6216\u819d\u5173\u8282PJI\u60a3\u8005\u8fdb\u884c2\u5e74\u968f\u8bbf\u7684\u4e00\u9879\u89c2\u5bdf\u6027\u7814\u7a76\u4e2d\uff0c\u5bf9\u4e8e\u65e9\u671f\u3001\u665a\u671f\u6025\u6027\u548c\u6162\u6027PJI, DAIR\u6210\u529f\u7387\uff08\u5b9a\u4e49\u4e3a\u9996\u6b21\u5047\u4f53\u690d\u5165\u540e\u4e34\u5e8a\u6cbb\u6108\uff09\u5206\u522b\u4e3a74%\u300149%\u548c44% 79\u3002\u4e0e\u63a5\u53d7\u975e\u611f\u67d3\u6027\u5168\u9acb\u5173\u8282\u7f6e\u6362\u672f\u7684\u60a3\u8005\u76f8\u6bd4\uff0c\u9acb\u5173\u8282PJI\u60a3\u8005\u7684\u751f\u6d3b\u8d28\u91cf\u548c\u5173\u8282\u529f\u80fd\u8f83\u4f4e\uff0c\u5e76\u4e14\u66f4\u6709\u53ef\u80fd\u9700\u8981\u751f\u6d3b\u8f85\u52a9\uff0821% vs. 12%\uff09\u548c\u79fb\u52a8\u8f85\u52a9\u8bbe\u5907\uff0865% vs. 42%\uff0996\u3002<\/p>\n
PJI\u5bf9\u60a3\u8005\u7684\u751f\u6d3b\u4ea7\u751f\u4e86\u8d1f\u9762\u5f71\u54cd\uff0c\u5305\u62ec\u8eab\u4f53\u3001\u793e\u4f1a\u548c\u60c5\u7eea\u65b9\u9762\u7684\u5f71\u54cd\uff0c\u539f\u56e0\u5305\u62ec\u9ad8\u518d\u5165\u9662\u7387\u3001\u6602\u8d35\u7684\u91cd\u590d\u64cd\u4f5c\u3001\u4f4f\u9662\u65f6\u95f4\u5ef6\u957f\u3001\u95e8\u8bca\u670d\u52a1\u4f7f\u7528\u589e\u52a0\u548c\u6297\u751f\u7d20\u7528\u836f\u65f6\u95f4\u5ef6\u957f\u3002\u8eab\u4f53\u529f\u80fd\u5dee\u3001\u5367\u5e8a\u4e0d\u8d77\u3001\u957f\u671f\u6297\u751f\u7d20\u6cbb\u7597\u3001\u65e0\u6cd5\u72ec\u7acb\u751f\u6d3b\u4ee5\u53ca\u5bb3\u6015\u75be\u75c5\u8fdb\u5c55\u6216\u6b7b\u4ea1\u4f1a\u5bfc\u81f4\u5fc3\u7406\u793e\u4f1a\u75db\u82e6\u3001\u5b64\u7acb\u3001\u4e0d\u5b89\u5168\u611f\u4ee5\u53ca\u6291\u90c1\u548c\u7126\u8651\uff0c\u5176\u6c34\u5e73\u4e0e\u764c\u75c7\u60a3\u8005\u76f8\u4f3c92\u3002\u7531\u4e8e\u9700\u8981\u8f83\u957f\u65f6\u95f4\u624d\u80fd\u786e\u5b9a\u6cbb\u6108\u65b9\u6cd5\uff0c\u56e0\u6b64\u53ef\u80fd\u4f1a\u51fa\u73b0\u4e34\u5e8a\u4e0a\u663e\u8457\u7684\u76f8\u5173\u6291\u90c1\u548c\u7126\u8651\uff0c\u5373\u4f7f\u5728\u6210\u529f\u6cbb\u7597\u7684\u75c5\u4f8b\u4e2d\u4e5f\u662f\u5982\u6b6492\u3002\u5bf9\u4e8e\u533b\u7597\u56e2\u961f\u800c\u8a00\uff0cPJI\u53ef\u80fd\u5bfc\u81f4\u8d1f\u9762\u60c5\u7eea\u548c\u8ba4\u77e5\u529f\u80fd\u969c\u788d\uff0c\u4ece\u800c\u5bfc\u81f4\u804c\u4e1a\u5026\u6020\uff0c\u5c24\u5176\u662f\u5bf9\u4e8e\u53ef\u80fd\u611f\u5230\u6709\u8d23\u4efb\u7684\u5916\u79d1\u533b\u5e0897\u3002\u9acb\u5173\u8282PJI\u540e5\u5e74\u65f6\u7684\u6b7b\u4ea1\u7387\u4e3a21%\uff08\u662f\u57fa\u4e8e\u5e74\u9f84\u7684\u6b7b\u4ea1\u7387\u76844\u500d\uff0998\uff0c10\u5e74\u65f6\u7684\u6b7b\u4ea1\u7387\u4e3a45%\uff08vs.\u975e\u611f\u67d3\u6027\u5168\u9acb\u5173\u8282\u7f6e\u6362\u672f\u60a3\u8005\u7684\u6b7b\u4ea1\u7387\u4e3a29%\uff0996\u3002\u5bf9\u4e8e\u4e8c\u671f\u7ffb\u4fee\uff0c\u5168\u9acb\u5173\u8282\u7f6e\u6362\u672f\u540e\u76841\u5e74\u6b7b\u4ea1\u7387\u4e3a13%\uff0c\u5168\u819d\u5173\u8282\u7f6e\u6362\u672f\u540e\u76841\u5e74\u6b7b\u4ea1\u7387\u4e3a9% 93\u3002\u5728\u4e00\u9879\u7eb3\u516534\u4f8b\u60a3\u8005\u7684\u7814\u7a76\u4e2d\uff0c\u540c\u65f6\u6027PJI\u4e0e18%\u768430\u65e5\u6b7b\u4ea1\u7387\u76f8\u5173\uff1b\u975e\u8ba1\u5212\u518d\u6b21\u624b\u672f\u76841\u5e74\u7d2f\u79ef\u53d1\u751f\u7387\u4e3a25% 99\u3002<\/p>\n
\u524d\u666f<\/p>\n
\u5728\u8fc7\u53bb\u768420\u5e74\u91cc\uff0c\u6211\u4eec\u5bf9PJI\u672c\u8eab\u4f5c\u4e3a\u4e00\u79cd\u75be\u75c5\u5b9e\u4f53\u7684\u7406\u89e3\u53d6\u5f97\u4e86\u8fdb\u5c55\uff0c\u5c3d\u7ba1\u5927\u591a\u6570\u6570\u636e\u662f\u5173\u4e8e\u9acb\u5173\u8282\u548c\u819d\u5173\u8282PJI\u7684\u3002\u5176\u4ed6\u5173\u8282\u611f\u67d3\u9700\u8981\u66f4\u591a\u7684\u6570\u636e\u3002\u9057\u4f20\u6613\u611f\u6027\u9700\u8981\u8fdb\u4e00\u6b65\u7814\u7a76\u3002\u9488\u5bf9PJI\u7684\u751f\u7269\u819c\u7279\u6027\uff0c\u9700\u8981\u5728\u9884\u9632\u3001\u8bca\u65ad\u548c\u6cbb\u7597\u65b9\u9762\u53d6\u5f97\u8fdb\u5c55\u3002\u86cb\u767d\u8d28\u7ec4\u5b66\u548c\u57fa\u56e0\u7ec4\u5b66\u8bca\u65ad\u9700\u8981\u8fdb\u4e00\u6b65\u8bc4\u4f30100-102\u3002\u8003\u8651\u5230\u624b\u672f\u573a\u666f\u7684\u5dee\u5f02\u3001\u591a\u79cd\u5fae\u751f\u7269\u7c7b\u578b\u548c\u65b0\u51fa\u73b0\u7684\u6297\u751f\u7d20\u8010\u836f\u6027\uff0c\u6700\u597d\u5728\u5353\u8d8a\u7684\u4e13\u79d1\u4e2d\u5fc3\u8fdb\u884c\u4e2a\u4f53\u5316\u6cbb\u7597\u3002\u6211\u4eec\u9700\u8981\u786e\u5b9a\u6700\u4f73\u7684\u624b\u672f\u65b9\u6cd5\u548c\u836f\u7269\u6cbb\u7597\uff0c\u5305\u62ec\u7279\u5b9a\u6297\u751f\u7d20\u3001\u975e\u6297\u751f\u7d20\u7597\u6cd5\u4ee5\u53ca\u7ed9\u836f\u6301\u7eed\u65f6\u95f4\u548c\u9014\u5f84\u3002\u5173\u4e8ePJI\u9884\u9632\u548c\u6cbb\u7597\u7684\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u6b63\u5728\u8fdb\u884c\u4e2d\u3002\u533b\u7597\u4fdd\u9669\u7684\u62a5\u9500\u65b9\u5f0f\u5e94\u83b7\u5f97\u8db3\u591f\u597d\u7684\u4e34\u5e8a\u7ed3\u5c40\u3002<\/p>\n
\u4f5c\u8005\u4fe1\u606fRobin Patel, M.D.From the Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, and the Division of Public Health, Infectious Diseases, and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, MN. Dr. Patel can be contacted at patel.robin@mayo.edu or at Mayo Clinic, 200 First St. SW, Rochester, MN 55905.\u53c2\u8003\u6587\u732e<\/p>\n
1. Tai DBG, Patel R, Abdel MP, Berbari EF, Tande AJ. Microbiology of hip and knee periprosthetic joint infections: a database study. Clin Microbiol Infect 2022;28:255-259.<\/p>\n
2. Marigi EM, Bartels DW, Yoon JH, Sperling JW, Sanchez-Sotelo J. Antibiotic prophylaxis with cefazolin is associated with lower shoulder periprosthetic joint infection rates than non-cefazolin alternatives. J Bone Joint Surg Am 2022;104:872-880.<\/p>\n
3. Kurtz SM, Lau E, Schmier J, Ong KL, Zhao K, Parvizi J. Infection burden for hip and knee arthroplasty in the United States. J Arthroplasty 2008;23:984-991.<\/p>\n
4. Premkumar A, Kolin DA, Farley KX, et al. Projected economic burden of periprosthetic joint infection of the hip and knee in the United States. J Arthroplasty 2021;36(5):1484-1489.e3.<\/p>\n
5. Kim HS, Park JW, Moon SY, Lee YK, Ha YC, Koo KH. Current and future burden of periprosthetic joint infection from national claim database. J Korean Med Sci 2020;35(49):e410-e410.<\/p>\n
6. Gundtoft PH, Pedersen AB, Sch\u00f8nheyder HC, M\u00f8ller JK, Overgaard S. One-year incidence of prosthetic joint infection in total hip arthroplasty: a cohort study with linkage of the Danish Hip Arthroplasty Register and Danish Microbiology Databases. Osteoarthritis Cartilage 2017;25:685-693.<\/p>\n
7. Triantafyllopoulos GK, Soranoglou VG, Memtsoudis SG, Sculco TP, Poultsides LA. Rate and risk factors for periprosthetic joint infection among 36,494 primary total hip arthroplasties. J Arthroplasty 2018;33:1166-1170.<\/p>\n
8. Koh CK, Zeng I, Ravi S, Zhu M, Vince KG, Young SW. Periprosthetic joint infection is the main cause of failure for modern knee arthroplasty: an analysis of 11,134 knees. Clin Orthop Relat Res 2017;475:2194-2201.<\/p>\n
9. McMaster Arthroplasty Collaborative (MAC). Incidence and predictors of prosthetic joint infection following primary total knee arthroplasty: a 15-year population-based cohort study. J Arthroplasty 2022;37(2):367-372.e1.<\/p>\n
10. McMaster Arthroplasty Collaborative (MAC). Risk factors for periprosthetic joint infection following primary total hip arthroplasty: a 15-year, population-based cohort study. J Bone Joint Surg Am 2020;102:503-509.<\/p>\n
11. Esposito CI. CORR Insights: periprosthetic joint infection is the main cause of failure for modern knee arthroplasty: an analysis of 11,134 knees. Clin Orthop Relat Res 2017;475:2202-2204.<\/p>\n
12. Kapadia BH, Banerjee S, Cherian JJ, Bozic KJ, Mont MA. The economic impact of periprosthetic infections after total hip arthroplasty at a specialized tertiary-care center. J Arthroplasty 2016;31:1422-1426.<\/p>\n
13. Kapadia BH, McElroy MJ, Issa K, Johnson AJ, Bozic KJ, Mont MA. The economic impact of periprosthetic infections following total knee arthroplasty at a specialized tertiary-care center. J Arthroplasty 2014;29:929-932.<\/p>\n
14. Garfield K, Noble S, Lenguerrand E, et al. What are the inpatient and day case costs following primary total hip replacement of patients treated for prosthetic joint infection: a matched cohort study using linked data from the National Joint Registry and Hospital Episode Statistics. BMC Med 2020;18:335-335.<\/p>\n
15. Parisi TJ, Konopka JF, Bedair HS. What is the long-term economic societal effect of periprosthetic infections after THA? A Markov analysis. Clin Orthop Relat Res 2017;475:1891-1900.<\/p>\n
16. Sousa A, Carvalho A, Pereira C, et al. Economic impact of prosthetic joint infection \u2014 an evaluation within the Portuguese National Health System. J Bone Jt Infect 2018;3:197-202.<\/p>\n
17. Yao JJ, Hevesi M, Visscher SL, et al. Direct inpatient medical costs of operative treatment of periprosthetic hip and knee infections are twofold higher than those of aseptic revisions. J Bone Joint Surg Am 2021;103:312-318.<\/p>\n
18. American Academy of Orthopaedic Surgeons. Diagnosis and prevention of periprosthetic joint infections: evidence-based clinical practice guideline. March 11, 2019 (https:\/\/www.\/globalassets\/quality-and-practice-resources\/pji\/diagnosisandpreventionofperiprostheticjointinfections-7-24-19.pdf).<\/p>\n
19. Humphrey TJ, Tatara AM, Bedair HS, Alpaugh K, Melnic CM, Nelson SB. Rates and outcomes of periprosthetic joint infection in persons who inject drugs. J Arthroplasty 2023;38:152-157.<\/p>\n
20. Alamanda VK, Springer BD. The prevention of infection: 12 modifiable risk factors. Bone Joint J 2019;101-B(1):Suppl A:3-9.<\/p>\n
21. B\u00fclow E, Hahn U, Andersen IT, Rolfson O, Pedersen AB, Hailer NP. Prediction of early periprosthetic joint infection after total hip arthroplasty. Clin Epidemiol 2022;14:239-253.<\/p>\n
22. Avila A, Acu\u00f1a AJ, Do MT, Samuel LT, Kamath AF. Intra-articular injection receipt within 3 months prior to primary total knee arthroplasty is associated with increased periprosthetic joint infection risk. Knee Surg Sports Traumatol Arthrosc 2022;30:4088-4097.<\/p>\n
23. Avila A, Do MT, Acu\u00f1a AJ, Samuel LT, Kamath AF. How do pre-operative intra-articular injections impact periprosthetic joint infection risk following primary total hip arthroplasty? A systematic review and meta-analysis. Arch Orthop Trauma Surg 2022 February 12 (Epub ahead of print).<\/p>\n
24. Komnos GA, Manrique J, Goswami K, et al. Periprosthetic joint infection in patients who have multiple prostheses in place: what should be done with the silent prosthetic joints. J Bone Joint Surg Am 2020;102:1160-1168.<\/p>\n
25. DeKeyser GJ, Anderson MB, Meeks HD, Pelt CE, Peters CL, Gililland JM. Socioeconomic status may not be a risk factor for periprosthetic joint infection. J Arthroplasty 2020;35:1900-1905.<\/p>\n
26. Lieber AM, Kirchner GJ, Kerbel YE, Moretti VM, Vakil JJ, Brahmabhatt S. Socioeconomic status is associated with risk of above-knee amputation after periprosthetic joint infection of the knee. Clin Orthop Relat Res 2019;477:1531-1536.<\/p>\n
27. Kirchner GJ, Lieber AM, Kim RY, Kerbel YE, Moretti VM, Nikkel LE. Socioeconomic status is associated with the risk of Girdlestone resection arthroplasty after periprosthetic infection of the hip. J Am Acad Orthop Surg 2021;29:439-445.<\/p>\n
28. Wang Q, Goswami K, Shohat N, Aalirezaie A, Manrique J, Parvizi J. Longer operative time results in a higher rate of subsequent periprosthetic joint infection in patients undergoing primary joint arthroplasty. J Arthroplasty 2019;34:947-953.<\/p>\n
29. Siddiqi A, Alamanda VK, Barrington JW, et al. Effects of hospital and surgeon volume on patient outcomes after total joint arthroplasty: reported from the American Joint Replacement Registry. J Am Acad Orthop Surg 2022;30(11):e811-e821.<\/p>\n
30. Ribau AI, Collins JE, Chen AF, Sousa RJ. Is preoperative Staphylococcus aureus screening and decolonization effective at reducing surgical site infection in patients undergoing orthopedic surgery? A systematic review and meta-analysis with a special focus on elective total joint arthroplasty. J Arthroplasty 2021;36(2):752-766.e6.<\/p>\n
31. Lin L, Ke Z-Y, Wang Y, Chen X-L, Zhong D, Cheng S. Efficacy of preoperative screening and decolonization for Staphylococcus aureus in total joint arthroplasty: a meta-analysis. Asian J Surg 2021;44:807-818.<\/p>\n
32. Berr\u00edos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg 2017;152:784-791.<\/p>\n
33. Buchalter DB, Nduaguba A, Teo GM, Kugelman D, Aggarwal VK, Long WJ. Cefazolin remains the linchpin for preventing acute periprosthetic joint infection following primary total knee arthroplasty. Bone Jt Open 2022;3:35-41.<\/p>\n
34. Ortiz D III, Teo GM, Lygrisse K, Aggarwal VK, Long WJ. Increased rate of early periprosthetic joint infection in total hip arthroplasty with the use of alternatives to cefazolin despite additional gram-negative coverage. Arthroplast Today 2022;14:183-188.<\/p>\n
35. Wyles CC, Hevesi M, Osmon DR, et al. 2019 John Charnley Award: increased risk of prosthetic joint infection following primary total knee and hip arthroplasty with the use of alternative antibiotics to cefazolin: the value of allergy testing for antibiotic prophylaxis. Bone Joint J 2019;101-B(6):Suppl B:9-15.<\/p>\n
36. Zastrow RK, Huang H-H, Galatz LM, Saunders-Hao P, Poeran J, Moucha CS. Characteristics of antibiotic prophylaxis and risk of surgical site infections in primary total hip and knee arthroplasty. J Arthroplasty 2020;35:2581-2589.<\/p>\n
37. Wu VJ, Iloanya MC, Sanchez FL, et al. Is patient-reported penicillin allergy independently associated with increased risk of prosthetic joint infection after total joint arthroplasty of the hip, knee, and shoulder? Clin Orthop Relat Res 2020;478:2699-2709.<\/p>\n
38. Shenoy ES, Macy E, Rowe T, Blumenthal KG. Evaluation and management of penicillin allergy: a review. JAMA 2019;321:188-199.<\/p>\n
39. Global guidelines for the prevention of surgical site infection. Geneva: World Health Organization, 2018.<\/p>\n
40. Christensen DD, Moschetti WE, Brown MG, et al. Perioperative antibiotic prophylaxis: single and 24-hour antibiotic dosages are equally effective at preventing periprosthetic joint infection in total joint arthroplasty. J Arthroplasty 2021;36(7):Suppl:S308-S313.<\/p>\n
41. Kuo F-C, Tan TL, Wang J-W, Wang C-J, Ko J-Y, Lee MS. Use of antimicrobial-impregnated incise drapes to prevent periprosthetic joint infection in primary total joint arthroplasty: a retrospective analysis of 9774 cases. J Arthroplasty 2020;35:1686-1691.<\/p>\n
42. Yazdi H, Klement MR, Hammad M, et al. Tranexamic acid is associated with reduced periprosthetic joint infection after primary total joint arthroplasty. J Arthroplasty 2020;35:840-844.<\/p>\n
43. Hong GJ, Wilson LA, Liu J, Memtsoudis SG. Tranexamic acid administration is associated with a decreased odds of prosthetic joint infection following primary total hip and primary total knee arthroplasty: a national database analysis. J Arthroplasty 2021;36:1109-1113.<\/p>\n
44. Kobayashi N, Kamono E, Maeda K, Misumi T, Yukizawa Y, Inaba Y. Effectiveness of diluted povidone-iodine lavage for preventing periprosthetic joint infection: an updated systematic review and meta-analysis. J Orthop Surg Res 2021;16:569-569.<\/p>\n
45. Driesman A, Shen M, Feng JE, et al. Perioperative chlorhexidine gluconate wash during joint arthroplasty has equivalent periprosthetic joint infection rates in comparison to betadine wash. J Arthroplasty 2020;35:845-848.<\/p>\n
46. Buchalter DB, Kirby DJ, Teo GM, Iorio R, Aggarwal VK, Long WJ. Topical vancomycin powder and dilute povidone-iodine lavage reduce the rate of early periprosthetic joint infection after primary total knee arthroplasty. J Arthroplasty 2021;36(1):286-290.e1.<\/p>\n
47. Hanada M, Nishikino S, Hotta K, Furuhashi H, Hoshino H, Matsuyama Y. Intrawound vancomycin powder increases post-operative wound complications and does not decrease periprosthetic joint infection in primary total and unicompartmental knee arthroplasties. Knee Surg Sports Traumatol Arthrosc 2019;27:2322-2327.<\/p>\n
48. Osmon DR, Berbari EF, Berendt AR, et al. Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2013;56(1):e1-e25.<\/p>\n
49. Parvizi J, Zmistowski B, Berbari EF, et al. New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res 2011;469:2992-2994.<\/p>\n
50. Shohat N, Bauer T, Buttaro M, et al. Hip and knee section, what is the definition of a periprosthetic joint infection (PJI) of the knee and the hip? Can the same criteria be used for both joints?: proceedings of International Consensus on Orthopedic Infections. J Arthroplasty 2019;34(2):Suppl:S325-S327.<\/p>\n
51. Parvizi J, Tan TL, Goswami K, et al. The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria. J Arthroplasty 2018;33(5):1309-1314.e2.<\/p>\n
52. McNally M, Sousa R, Wouthuyzen-Bakker M, et al. The EBJIS definition of periprosthetic joint infection. Bone Joint J 2021;103-B:18-25.<\/p>\n
53. B\u00e9mer P, L\u00e9ger J, Milin S, et al. Histopathological diagnosis of prosthetic joint infection: does a threshold of 23 neutrophils do better than classification of the periprosthetic membrane in a prospective multicenter study? J Clin Microbiol 2018;56(9):e00536-18-e00536-18.<\/p>\n
54. Klement MR, Siddiqi A, Rock JM, Chen AF, Bolognesi MP, Seyler TM. Positive blood cultures in periprosthetic joint infection decrease rate of treatment success. J Arthroplasty 2018;33(1):200-204.e1.<\/p>\n
55. Rockov ZA, Clarke HD, Grys TE, Chang Y-HH, Schwartz AJ. Is there an optimal cutoff for aspiration fluid volume in the diagnosis of periprosthetic joint infection? J Arthroplasty 2020;35:2217-2222.<\/p>\n
56. Peng X, Zhang H, Xin P, et al. Synovial calprotectin for the diagnosis of periprosthetic joint infection: a diagnostic meta-analysis. J Orthop Surg Res 2022;17:2-2.<\/p>\n
57. Kleeman-Forsthuber LT, Johnson RM, Brady AC, Pollet AK, Dennis DA, Jennings JM. Alpha-defensin offers limited utility in routine workup of periprosthetic joint infection. J Arthroplasty 2021;36:1746-1752.<\/p>\n
58. Ivy MI, Sharma K, Greenwood-Quaintance KE, et al. Synovial fluid \u03b1 defensin has comparable accuracy to synovial fluid white blood cell count and polymorphonuclear percentage for periprosthetic joint infection diagnosis. Bone Joint J 2021;103-B:1119-1126.<\/p>\n
59. Wouthuyzen-Bakker M, Tornero E, Claret G, et al. Withholding preoperative antibiotic prophylaxis in knee prosthesis revision: a retrospective analysis on culture results and risk of infection. J Arthroplasty 2017;32:2829-2833.<\/p>\n
60. Sigmund IK, Holinka J, Lang S, et al. A comparative study of intraoperative frozen section and alpha defensin lateral flow test in the diagnosis of periprosthetic joint infection. Acta Orthop 2019;90:105-110.<\/p>\n
61. Walker LC, Clement ND, Wilson I, Hashmi M, Samuel J, Deehan DJ. The importance of multi-site intra-operative tissue sampling in the diagnosis of hip and knee periprosthetic joint infection \u2014 results from a single centre study. J Bone Jt Infect 2020;5:151-159.<\/p>\n
62. Boyle KK, Kapadia M, Chiu Y-F, et al. The James A. Rand Young Investigator's Award: are intraoperative cultures necessary if the aspiration culture is positive? A concordance study in periprosthetic joint infection. J Arthroplasty 2021;36(7):Suppl:S4-S10.<\/p>\n
63. Peel TN, Dylla BL, Hughes JG, et al. Improved diagnosis of prosthetic joint infection by culturing periprosthetic tissue specimens in blood culture bottles. mBio 2016;7(1):e01776-15.<\/p>\n
64. Peel TN, Spelman T, Dylla BL, et al. Optimal periprosthetic tissue specimen number for diagnosis of prosthetic joint infection. J Clin Microbiol 2016;55:234-243.<\/p>\n
65. Tai DBG, Wengenack NL, Patel R, Berbari EF, Abdel MP, Tande AJ. Fungal and mycobacterial cultures should not be routinely obtained for diagnostic work-up of patients with suspected periprosthetic joint infections. Bone Joint J 2022;104-B:53-58.<\/p>\n
66. Trampuz A, Piper KE, Jacobson MJ, et al. Sonication of removed hip and knee prostheses for diagnosis of infection. N Engl J Med 2007;357:654-663.<\/p>\n
67. Rieber H, Frontzek A, Heinrich S, et al. Microbiological diagnosis of polymicrobial periprosthetic joint infection revealed superiority of investigated tissue samples compared to sonicate fluid generated from the implant surface. Int J Infect Dis 2021;106:302-307.<\/p>\n
68. Marazzi MG, Randelli F, Brioschi M, et al. Presepsin: a potential biomarker of PJI? A comparative analysis with known and new infection biomarkers. Int J Immunopathol Pharmacol 2018;31:394632017749356-394632017749356.<\/p>\n
69. Flurin L, Wolf M, Mutchler M, Daniels M, Wengenack N, Patel R. Targeted metagenomic sequencing-based approach applied to 2,146 tissue and body fluid samples in routine clinical practice. Clin Infect Dis 2022;75:1800-1808.<\/p>\n
70. Hong HL, Flurin L, Thoendel MJ, et al. Targeted versus shotgun metagenomic sequencing-based detection of microorganisms in sonicate fluid for periprosthetic joint infection diagnosis. Clin Infect Dis 2022 August 9 (Epub ahead of print).<\/p>\n
71. Thoendel MJ, Jeraldo PR, Greenwood-Quaintance KE, et al. Identification of prosthetic joint infection pathogens using a shotgun metagenomics approach. Clin Infect Dis 2018;67:1333-1338.<\/p>\n
72. Huang Z, Li W, Lee G-C, et al. Metagenomic next-generation sequencing of synovial fluid demonstrates high accuracy in prosthetic joint infection diagnostics: mNGS for diagnosing PJI. Bone Joint Res 2020;9:440-449.<\/p>\n
73. Cai Y, Fang X, Chen Y, et al. Metagenomic next generation sequencing improves diagnosis of prosthetic joint infection by detecting the presence of bacteria in periprosthetic tissues. Int J Infect Dis 2020;96:573-578.<\/p>\n
74. Echeverria AP, Cohn IS, Danko DC, et al. Sequencing of circulating microbial cell-free DNA can identify pathogens in periprosthetic joint infections. J Bone Joint Surg Am 2021;103:1705-1712.<\/p>\n
75. Kildow BJ, Ryan SP, Danilkowicz R, et al. Next-generation sequencing not superior to culture in periprosthetic joint infection diagnosis. Bone Joint J 2021;103-B:26-31.<\/p>\n
76. Flurin L, Hemenway JJ, Fisher CR, et al. Clinical use of a 16S ribosomal RNA gene-based Sanger and\/or next generation sequencing assay to test preoperative synovial fluid for periprosthetic joint infection diagnosis. mBio 2022;13(6):e01322-e01322.<\/p>\n
77. Azad MA, Wolf MJ, Strasburg AP, et al. Comparison of the BioFire Joint Infection panel to 16S ribosomal RNA gene-based targeted metagenomic sequencing for testing synovial fluid from patients with knee arthroplasty failure. J Clin Microbiol 2022;60(12):e0112622-e0112622..<\/p>\n
78. Bedair HS, Katakam A, Bedeir YH, Yeroushalmi D, Schwarzkopf R. A decision analysis of treatment strategies for acute periprosthetic joint infection: early irrigation and debridement versus delayed treatment based on organism. J Orthop 2020;22:246-250.<\/p>\n
79. Davis JS, Metcalf S, Clark B, et al. Predictors of treatment success after periprosthetic joint infection: 24-month follow up from a multicenter prospective observational cohort study of 653 patients. Open Forum Infect Dis 2022;9:ofac048-ofac048.<\/p>\n
80. Wouthuyzen-Bakker M, Sebillotte M, Huotari K, et al. Lower success rate of debridement and implant retention in late acute versus early acute periprosthetic joint infection caused by Staphylococcus spp. Results from a matched cohort study. Clin Orthop Relat Res 2020;478:1348-1355.<\/p>\n
81. Craig A, King SW, van Duren BH, Veysi VT, Jain S, Palan J. Articular spacers in two-stage revision arthroplasty for prosthetic joint infection of the hip and the knee. EFORT Open Rev 2022;7:137-152.<\/p>\n
82. Kunutsor SK, Whitehouse MR, Blom AW, et al. One- and two-stage surgical revision of peri-prosthetic joint infection of the hip: a pooled individual participant data analysis of 44 cohort studies. Eur J Epidemiol 2018;33:933-946.<\/p>\n
83. Belay ES, Danilkowicz R, Bullock G, Wall K, Garrigues GE. Single-stage versus two-stage revision for shoulder periprosthetic joint infection: a systematic review and meta-analysis. J Shoulder Elbow Surg 2020;29:2476-2486.<\/p>\n
84. Lazic I, Scheele C, Pohlig F, von Eisenhart-Rothe R, Suren C. Treatment options in PJI \u2014 is two-stage still gold standard? J Orthop 2021;23:180-184.<\/p>\n
85. Zahar A, Klaber I, Gerken AM, et al. Ten-year results following one-stage septic hip exchange in the management of periprosthetic joint infection. J Arthroplasty 2019;34:1221-1226.<\/p>\n
86. Abdelaziz H, Gr\u00fcber H, Gehrke T, Salber J, Citak M. What are the factors associated with re-revision after one-stage revision for periprosthetic joint infection of the hip? A case-control study. Clin Orthop Relat Res 2019;477:2258-2263.<\/p>\n
87. Bernard L, Arvieux C, Brunschweiler B, et al. Antibiotic therapy for 6 or 12 weeks for prosthetic joint infection. N Engl J Med 2021;384:1991-2001.<\/p>\n
88. Winkler T, Stuhlert MGW, Lieb E, et al. Outcome of short versus long interval in two-stage exchange for periprosthetic joint infection: a prospective cohort study. Arch Orthop Trauma Surg 2019;139:295-303.<\/p>\n
89. Chieffo G, Corsia S, Rougereau G, et al. Six-week antibiotic therapy after one-stage replacement arthroplasty for hip and knee periprosthetic joint infection. Med Mal Infect 2020;50:567-574.<\/p>\n
90. Li H-K, Rombach I, Zambellas R, et al. Oral versus intravenous antibiotics for bone and joint infection. N Engl J Med 2019;380:425-436.<\/p>\n
91. Shah NB, Hersh BL, Kreger A, et al. Benefits and adverse events associated with extended antibiotic use in total knee arthroplasty periprosthetic joint infection. Clin Infect Dis 2020;70:559-565.<\/p>\n
92. Knebel C, Menzemer J, Pohlig F, et al. Peri-prosthetic joint infection of the knee causes high levels of psychosocial distress: a prospective cohort study. Surg Infect (Larchmt) 2020;21:877-883.<\/p>\n
93. Kurtz SM, Higgs GB, Lau E, Iorio RR, Courtney PM, Parvizi J. Hospital costs for unsuccessful two-stage revisions for periprosthetic joint infection. J Arthroplasty 2022;37:205-212.<\/p>\n
94. Barton CB, Wang DL, An Q, Brown TS, Callaghan JJ, Otero JE. Two-stage exchange arthroplasty for periprosthetic joint infection following total hip or knee arthroplasty is associated with high attrition rate and mortality. J Arthroplasty 2020;35:1384-1389.<\/p>\n
95. Corona PS, Vicente M, Carrera L, Rodr\u00edguez-Pardo D, Corr\u00f3 S. Current actual success rate of the two-stage exchange arthroplasty strategy in chronic hip and knee periprosthetic joint infection. Bone Joint J 2020;102-B:1682-1688.<\/p>\n
96. Wildeman P, Rolfson O, S\u00f6derquist B, Wretenberg P, Lindgren V. What are the long-term outcomes of mortality, quality of life, and hip function after prosthetic joint infection of the hip? A 10-year follow-up from Sweden. Clin Orthop Relat Res 2021;479:2203-2213.<\/p>\n
97. Mallon C, Gooberman-Hill R, Blom A, Whitehouse M, Moore A. Surgeons are deeply affected when patients are diagnosed with prosthetic joint infection. PLoS One 2018;13(11):e0207260-e0207260.<\/p>\n
98. Natsuhara KM, Shelton TJ, Meehan JP, Lum ZC. Mortality during total hip periprosthetic joint infection. J Arthroplasty 2019;34(7):Suppl:S337-S342.<\/p>\n
99. Gausden EB, Pagnano MW, Perry KI, Suh GA, Berry DJ, Abdel MP. Synchronous periprosthetic joint infections: high mortality, reinfection, and reoperation. J Arthroplasty 2021;36:3556-3561.<\/p>\n
100. Fisher CR, Salmons HI, Mandrekar J, Greenwood-Quaintance KE, Abdel MP, Patel R. A 92 protein inflammation panel performed on sonicate fluid differentiates periprosthetic joint infection from non-infectious causes of arthroplasty failure. Sci Rep 2022;12:16135-16135.<\/p>\n
101. Masters TL, Bhagwate AV, Dehankar MK, et al. Human transcriptomic response to periprosthetic joint infection. Gene 2022;825:146400-146400.<\/p>\n
102. Fisher CR, Krull JE, Bhagwate A, et al. Sonicate fluid cellularity predicted by transcriptomic deconvolution differentiates infectious from noninfectious arthroplasty failure. J Bone Joint Surg Am (in press).<\/p>\n","protected":false},"excerpt":{"rendered":"
Periprosthetic Joint Infection \u5173\u8282\u7f6e\u6362\u672f\u76f8\u5173\u611f\u67d3 … \u7ee7\u7eed\u9605\u8bfb