文章摘要

髋关节广泛耐药性结核分枝杆菌感染诊治 1 例

作者: 1,2李聪, 1李旭升, 1张浩强, 1,3李鹏, 1,2程永刚, 1叶铄
1 中国人民解放军联勤保障部队第九四〇医院关节外科,兰州 730000
2 西北民族大学医学部,兰州 730000
3 甘肃中医药大学,兰州 730000
通讯: 叶铄 Email: 1977369231@qq.com
DOI: 10.3978/j.issn.2095-6959.2022.04.037
基金: 全军后勤科研计划面上项目(CWH17J009);中央高校基本科研业务费专项资金(31920200018);全军医学科技青年培育计划(19QNP047);甘肃省自然科学基金(18JR3RA403);甘肃省青年科技基金(18JR3RA410);甘肃省卫生行业科研计划项目(GSWSKY2018-21,GSWSKY2019-94);兰州市人才创新创业项目(2019-RC-65)。

摘要

髋关节广泛耐药性结核菌感染临床少见,其确诊所需时间较长,往往确诊时已为晚期,对髋关 节的结构和功能已造成巨大破坏,治疗复杂,给患者造成了沉重的负担。中国人民解放军联勤 保障部队第九四〇医院收治的1例以左髋关节疼痛为首发症状的年轻患者,初步考虑为左髋关节 结核,经一期骨水泥旷置术及规律抗结核治疗5个月后感染复发,二次旷置并行基因检测后确诊 为左髋关节广泛耐药性结核分枝杆菌感染。
关键词: 广泛耐药性结核分枝杆菌;髋关节二期翻修术;抗结核治疗

Diagnosis and treatment of extensively drug-resistant mycobacterium tuberculosis infection of hip joint: A case report

Authors: 1,2LI Cong, 1LI Xusheng, 1ZHANG Haoqiang, 1,3LI Peng, 1,2CHENG Yonggang, 1YE Shuo
1 Department of Joint Surgery, 940th Hospital of PLA Joint Logistics Support Force, Lanzhou 730000, China
2 Medical College of Northwest Minzu University, Lanzhou 730000, China
3 Gansu University of Traditional Chinese Medicine, Lanzhou 730000, China

CorrespondingAuthor: YE Shuo Email: 1977369231@qq.com

DOI: 10.3978/j.issn.2095-6959.2022.04.037

Foundation: This work was supported by the Military Logistics Research Project (CWH17J009), the Fundamental Research Funds for the Central Universities (31920200018), the Military Medical Science and Technology Youth Development Program (19QNP047), Natural Science Foundation of Gansu Province (18JR3RA403), the Youth Science and Technology Foundation of Gansu Province (18JR3RA410), the Health Industry Research Plan Project of Gansu Province (GSWSKY2018-21, GSWSKY2019-94), and the Lanzhou Talent Innovation and Entrepreneurship Project (2019-RC-65), China.

Abstract

Extensively drug-resistant mycobacterium tuberculosis infection of the hip joint is rare in clinical practice, and its diagnosis requires a long median time. It is often at an advanced stage at the time of diagnosis. It has caused great damage to the structure and function of the hip joint, and its treatment is complicated, which causes a heavy burden on patients. A young patient with left hip joint pain as the first symptom was admitted to our hospital, initially he was considered having mycobacterium tuberculosis infection of the left hip joint. But the infection recurred after 5 mouths with a primary bone cement exclusion surgery and regular anti-tuberculosis treatment. So we had to perform the second surgery and genetic testing. Later, he was diagnosed as extensively drug-resistant mycobacterium tuberculosis infection in the left hip joint.
Keywords: extensively drug-resistant mycobacterium tuberculosis; second-stage total arthroplasty of the hip joint; anti- tuberculosis treatment