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고관절 인공 관절 치환술 후 감염의 치료

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참고문헌

초록

인공 관절의 감염은 수술 전에 주위 깊은 검사와 수술계획을 요하는 주요한 합병증이다. 즉각적인 진단과 조기에 수술을 하도록 하며, 특히 급성 감염과 혈행성 감염의경우 이는 더욱 중요하다 하겠다. 완벽한 진단 방법은 없지만 임상적 검사와 혈청학적 검사, 방사선 검사 및 세균학적 분석을 포괄적으로 이용하여 진단을 할 경우 신뢰도를높일수있다.철저한 병력 청취와 임상 검사, 위험 인자의 파악과 더불어 환자의 증상, 감염의 증후 및 ESR, CRP 검사가 이루어져야 한다. 방사선 검사의 경우 주기적인 간격으로 촬영한 일련의 필름을 비교하여 다른 진단을 배제시키고, 이를기초로 필요한 추가 검사가 이루어지는 동시에 치료도 시작되어야 한다. 여러 가지 새로운 영상기법이 있지만 아직까지 인공관절 감염의 진단에 단독적으로 신뢰할 수는 없다. 수술 전에 세침 흡입 검사를 시행해야 하고 만약 음성이라고 하더라도 감염의 가능성이 높다면 반복 시술을 고려하여야 한다. 수술적 처치의 역할은 분명하며 최근에는2단계 재치환술이 지지를 받고 있고, articulating spacer를 사용하여 높은 감염 치유율을 보이고 있다.

참고문헌 (235)

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