Проблема периоперационного прогнозирования гнойных осложнений эндопротезирования тазобедренного и коленного суставов. Часть II (обзор литературы)

Автор: Брагина Светлана Валентиновна, Москалв Валерий Петрович, Петрушин Александр Леонидович, Березин Павел Андреевич

Журнал: Гений ортопедии @geniy-ortopedii

Рубрика: Обзор литературы

Статья в выпуске: 4 т.28, 2022 года.

Бесплатный доступ

Введение. В попытке уменьшения риска развития гнойных осложнений артропластики тазобедренного и коленного суставов исследователи изучают возможности влияния на факторы риска в периоперационном периоде. Цель. Систематизация информации о потенциально модифицируемых факторах риска гнойных осложнений эндопротезирования тазобедренного и коленного суставов и возможностях влияния на них. Материалы и методы. Поиск литературных источников проводился в открытых электронных базах данных научной литературы PubMed, eLIBRARY, Scopus, Dimensions. Глубина поиска - 30 лет. Результаты. В обзоре проанализированы потенциально модифицируемые факторы риска и возможности влияния на них в периоперационном периоде. Часто пациенты с показаниями для эндопротезирования крупных суставов имеют коморбидную патологию, которую необходимо компенсировать на этапе подготовки к хирургическому вмешательству и в послеоперационном периоде. В том числе это может быть патология суставов: олиго-, полиостеоартроз, артропластика других суставов, септический артрит или перипротезная инфекция в анамнезе. Соматические заболевания нередко связаны с отклонением от нормы определенных лабораторных показателей. Все эти факторы риска не могут быть полностью устранены и расцениваются как неблагоприятный фон для проведения эндопротезирования тазобедренного и коленного суставов. Дискуссия. Современный уровень информации о возможных рисках развития гнойных осложнений артропластики тазобедренного и коленного суставов не всегда позволяет повлиять на снижение частоты возникновения инфекционных осложнений. Сохраняется неопределенность в отношении некоторых предикторов инфекции области хирургического вмешательства, перипротезной инфекции. Не всегда имеется однозначная причинно-следственная связь между потенциально неблагоприятным фоном пациента и негативным результатом операции, что требует дальнейшего углублённого изучения данной проблемы.

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Эндопротезирование суставов, инфекция области хирургического вмешательства, перипротезная инфекция, прогнозирование, факторы риска

Короткий адрес: https://sciup.org/142235729

IDR: 142235729   |   DOI: 10.18019/1028-4427-2022-28-4-608-618

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