CAJ | 학술논문

目的评价含庆大霉素羟基磷灰石(hydroxyapatite,HA)涂层假体控制关节置换术后感染的效果.方法采用仿生溶液法制备含庆大霉素HA涂层假体,在体外实验中检测庆大霉素的释放情况.将50只中国白兔分成5组,每组10只,第1组植入HA假体,第2组带菌植入HA假体,第3组带菌植入含庆大霉素HA假体,第4组带菌植入HA假体并肌内注射庆大霉素,第5组带菌植入含庆大霉素HA假体并肌内注射庆大霉素.手术当天及术后第28天拍摄左胫骨X线片,进行评分;术前、术后第3、7、14、21、28天检测血常规、红细胞沉降率、肛温和体重;术后第28天处死动物.对髓腔和假体进行细菌培养,对骨标本进行组织学观察.结果含庆大霉素HA涂层假体在体外释放庆大霉素可达到金黄色葡萄球菌的最低抑菌浓度.并可持续10 d以上.第1组无感染,第2组全部感染,第3组6只感染,第4组6只感染,第5组3只感染.第2、3组体温比第4、5组高;影像学评分、血常规、红细胞沉降率和体重各项组间比较差异均无统计学意义;细菌菌落数比较,第2组>第4组>第3组>第5组.结论含庆大霉素HA涂层假体能够和全身应用抗生素协同,较好地控制局部感染.
목적 평개함경대매소간기린회석(hydroxyapatite,HA)도층가체공제관절치환술후감염적효과.방법 채용방생용액법제비함경대매소HA도층가체,재체외실험중검측경대매소적석방정황.장50지중국백토분성5조,매조10지,제1조식입HA가체,제2조대균식입HA가체,제3조대균식입함경대매소HA가체,제4조대균식입HA가체병기내주사경대매소,제5조대균식입함경대매소HA가체병기내주사경대매소.수술당천급술후제28천박섭좌경골X선편,진행평분;술전、술후제3、7、14、21、28천검측혈상규、홍세포침강솔、항온화체중;술후제28천처사동물.대수강화가체진행세균배양,대골표본진행조직학관찰.결과 함경대매소HA도층가체재체외석방경대매소가체도금황색포도구균적최저억균농도.병가지속10 d이상.제1조무감염,제2조전부감염,제3조6지감염,제4조6지감염,제5조3지감염.제2、3조체온비제4、5조고;영상학평분、혈상규、홍세포침강솔화체중각항조간비교차이균무통계학의의;세균균락수비교,제2조>제4조>제3조>제5조.결론 함경대매소HA도층가체능구화전신응용항생소협동,교호지공제국부감염.
Objective To assess the effect of the prosthesis costed with hydroxyapatite (HA) combined with gentamicin on preventing infections after arthroplasty. Methods Examining the concentration and the time of gentamicin released from the prosthesis. Fifty Chinese white rabbits were divided into five groups averagnly. All rabbits in each group were processed according to the experimental designs. The rabbits were taken X-ray examination on the operation day and the postoperative 28th day on the left tibia and radiological assessment was done. Blood routine examination, erythrocyte sediment rate (ESR), body temperature and weight were examined before the operation and on the 3rd, 7th, 14th, 21st, 28th day after the operation. Microbiological examination was done both on the bone and the prosthesis at the 28th days postoperatively. Calculating the clonal formation unit (CFU) number if there is colony emerging from the blood culture medium. And histology inspection was also done on the samples. Results The gentamicin released from the prosthesis with gentamicin-HA coating could reach the minimum inhibition concentration (MIC) of the staphylococcus and could persist for more than I0 days in vitro. There was no infected rabbit in group 1, 10 in group 2, 6 in group 3, 6 in group 4 and 3 in group 5. The mean body temperature of group 2 and group 3 is higher than that of group 4 and group 5; there, is no significant difference among the groups in terms of radiological assessment, blood routine examination, ESR and weight. The CFU number of bacteria cultured both from marrow cavity and prosthesis in group 2 is higher than that of group 4 which is higher than that of group 3 and group 5, while group 3's is higher than that of group 5. Conclusion The gentamicin released from the prosthesis with gentamicin-HA coating could reach the MIC of the staphylococcus and could persist for more than 10 days in vitro. The prosthesis with gentamicin-HA coating could locally help to reduce infection at a certain extent in collaboration with general antibiotics.