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J Bone Joint Surg:青少年感染性膝关节炎的独立危险因素有哪些?

2016-06-27 Mechront 译 MedSci原创

与莱姆病患者相比,化脓性关节炎更常见于不到2岁、伴有疼痛的短弧运动、C-反应蛋白水平大于4 mg/L和父母报道的发热史。研究人员对189名<18岁的膝关节穿刺、诊断为化脓性关节炎、莱姆病的患者进行了研究。结果显示,23例培养阳性的化脓性关节炎;26例培养阴性的感染性关节炎;140例莱姆病。研究人员发现,33%被诊断为莱姆病的患者是在手术切开引流的基础上推定诊断化脓性关节炎。莱姆关节炎患者行切开引流

与莱姆病患者相比,化脓性关节炎更常见于不到2岁、伴有疼痛的短弧运动、C-反应蛋白水平大于4 mg/L和父母报道的发热史。

研究人员对189名<18岁的膝关节穿刺、诊断为化脓性关节炎、莱姆病的患者进行了研究。结果显示,23例培养阳性的化脓性关节炎;26例培养阴性的感染性关节炎;140例莱姆病。研究人员发现,33%被诊断为莱姆病的患者是在手术切开引流的基础上推定诊断化脓性关节炎。莱姆关节炎患者行切开引流术与未行外科手术的患者相比,平均滑液白细胞计数、血白细胞计数、血沉、C-反应蛋白(CRP)水平的患者之间的显着差异。

根据多因素回归分析的结果,感染性关节炎的独立预测因子包括短弧运动疼痛、患者或家属的发热病史、CRP大于4mg/L ,年龄小于2岁。研究人员发现,一个因素都没有的患者,其感染性关节炎的风险为2%;当占有1个因素、2个因素、3个因素和4个因素时,风险分别为18%、45%、84%和100%。

预测模型表明,可以根据这4个因素区分化脓性关节炎和莱姆病,并且根据患者所占因素的多少,评估化脓性关节炎的风险,以及做出是否需要紧急手术的决策。

原始出处:


Baldwin KD, et al. Predictive Factors for Differentiating Between Septic Arthritis and Lyme Disease of the Knee in Children.J Bone Joint Surg. 2016;doi:10.2106/JBJS.14.01331.

Several independent risk factors for septic knee arthritis identified
.Healio.June 26, 2016

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    2016-10-08 1e128d2fm65(暂无匿称)

    jbjs文章权威性还是很高的

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2037170, encodeId=6da5203e17095, content=<a href='/topic/show?id=9be468126d4' target=_blank style='color:#2F92EE;'>#独立危险因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68126, encryptionId=9be468126d4, topicName=独立危险因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, createdName=spoonycyy, createdTime=Fri Sep 16 21:38:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655352, encodeId=72b116553528f, content=<a href='/topic/show?id=7c2853311ac' target=_blank style='color:#2F92EE;'>#感染性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53311, encryptionId=7c2853311ac, topicName=感染性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=583d24724321, createdName=charl1234575, createdTime=Sat Nov 05 21:38:00 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141774, encodeId=c88f141e7442, content=jbjs文章权威性还是很高的, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161012/IMG57FE37B9D8B7C2781.jpg, createdBy=05f31956923, createdName=1e128d2fm65(暂无匿称), createdTime=Sat Oct 08 08:50:55 CST 2016, time=2016-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1915138, encodeId=46b419151387d, content=<a href='/topic/show?id=05343619cf' target=_blank style='color:#2F92EE;'>#Bone#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3619, encryptionId=05343619cf, topicName=Bone)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7dc7399, createdName=apoenzyme, createdTime=Wed Mar 15 16:38:00 CST 2017, time=2017-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129413, encodeId=d25712941358, content=不错哦,会学到很多,喜欢梅斯医学文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sat Sep 17 11:44:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=123731, encodeId=8ca8123e31c7, content=关注值得学习。赞!好文有待探究。, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Sep 12 18:09:00 CST 2016, time=2016-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=107385, encodeId=d6cb10e38516, content=好文,值得学习,赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Aug 30 11:19:00 CST 2016, time=2016-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265318, encodeId=45f1126531897, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Wed Jun 29 05:38:00 CST 2016, time=2016-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521527, encodeId=d81c152152eed, content=<a href='/topic/show?id=17a38586839' target=_blank style='color:#2F92EE;'>#膝关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85868, encryptionId=17a38586839, topicName=膝关节炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1e3311361699, createdName=jiafufeng@yaho, createdTime=Wed Jun 29 05:38:00 CST 2016, time=2016-06-29, status=1, ipAttribution=)]
    2017-03-15 apoenzyme
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    2016-09-17 1e10c84am36(暂无匿称)

    不错哦,会学到很多,喜欢梅斯医学文章

    0

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    2016-09-12 ylzr123

    关注值得学习。赞!好文有待探究。

    0

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    2016-08-30 ylzr123

    好文,值得学习,赞!

    0

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    2016-06-29 lmm397
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