Adult osteomyelitis
Adult osteomyelitis
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DOI：
10.1016/j.idc.2005.07.009
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发表时间：
2005-12-01
影响因子：
4.4
通讯作者：
Manring, MM
中科院分区：
文献类型：
--
作者：
Calhoun, JH;Manring, MM
成人骨髓炎最常见的原因是开放性骨折、糖尿病足感染或闭合性损伤的手术治疗。患者通常有长期虚弱和多次手术的病史。由于诊断、手术和治疗技术的进步，骨髓炎的治疗在过去的25年里有了很大的改善。“治愈”一词不用于骨髓炎，因为如果患者的受累部位遭受新的创伤，或者宿主对感染的反应受到抑制，感染可能在明显成功的治疗后数年内复发。治疗的目标是阻止骨髓炎，而不是达到治愈。本文对成人骨髓炎进行了广泛的讨论。回顾了主要的分类系统，并简要讨论了血源性、椎源性、邻近病灶和慢性骨髓炎。讨论诊断，特别注意不同放射学技术的作用。最后，重点是不同类型的成人骨髓炎的各种治疗方法，包括涉及特殊患者群体的病例。
Adult osteomyelitis most commonly arises from open fractures, diabetic foot infections, or the surgical treatment of closed injuries. Patients usually have a history of prolonged debilitation and multiple surgical procedures. Treatment of osteomyelitis has improved considerably over the past quarter-century because of advances in diagnostic, surgical, and therapeutic techniques. The term "cure" is not used for osteomyelitis, because the infection may recur years after apparently successful treatment of the disease, if the patient suffers new trauma to the involved area, or the host response to the infection is suppressed. The goal of treatment is to arrest osteomyelitis, rather than achieve cure.This article provides a broad discussion of adult osteomyelitis. The major classification systems are reviewed, with brief discussions of hematogenous, vertebral, contiguous-focus, and chronic osteomyelitis. Diagnosis is discussed, with particular attention on the role of different radiologic technologies. Finally, the focus is various approaches to treatment for different types of adult osteomyelitis, including cases involving special patient populations.