慢性骨髓炎的耐药性感染及光动力疗法在其治疗中的应用

doi:10.3969/j.issn.1674-490X.2024.04.002

摘要/Abstract

摘要： 慢性骨髓炎是由病原菌引起的骨膜、骨质和骨髓的长期持续性炎症,是骨科最常见的慢性并发症之一,其临床治愈率极低,是医学上公认的顽疾。近年来,由于细菌生物膜的广泛形成,使其发病机制愈加复杂,炎症往往不受宿主免疫系统的防御,反复发作,导致骨质严重破坏,继而引起感染后期患肢的残障。目前临床上对该疾病的治疗以抗生素结合手术清创治疗为主, 但慢性骨髓炎的病理生理变化阻碍了抗生素的渗透,使其难以到达病变部位,同时,由于抗生素多重耐药现象逐渐严峻,也增加了慢性骨髓炎的治疗难度。因此迫切需要探寻到一种能够抗感染的治疗新手段。现就慢性骨髓炎的病因、致病机制、难治因素及光动力疗法在抗耐药菌感染方面的优势并结合其在慢性骨髓炎中的最新研究成果做一阐述。

关键词: 慢性骨髓炎, 生物膜, 抗生素耐药, 光动力疗法

Abstract: Chronic osteomyelitis is a long-term and persistent inflammation of the periosteum, bone and bone marrow caused by pathogenic bacteria, and is one of the most common chronic complications in orthopedics. In recent years, due to the extensive formation of bacterial biofilms, the pathogenesis of chronic osteomyelitis has become more complex, and inflammation is often not defended by the host immune system, and recurs, resulting in severe bone destruction and then disability of the affected limb in the later stage of infection. At present, the clinical treatment of this disease is mainly antibiotic combined with surgical debridement. However, the pathophysiological changes of chronic osteomyelitis hinder the penetration of antibiotics and make it difficult to reach the lesion site, and at the same time, due to the gradual severity of antibiotic multi-drug resistance, it also increases the difficulty of treatment of chronic osteomyelitis. Therefore, there is an urgent need to explore a new treatment method that can fight infection. This article reviews the etiology, pathogenic mechanism, refractory factors and the latest progress in the treatment of chronic osteomyelitis, focusing on the advantages of the new photodynamic therapy in the resistance to drug-resistant bacteria infection combined with the latest research results in chronic osteomyelitis.

Key words: chronic osteomyelitis, biofilm, antibotic resistance, photodynamic therapy

中图分类号:

左菊,杨小娜,郭思威,王熙钰,陈颖萱,赵占娟,赵建喜. 慢性骨髓炎的耐药性感染及光动力疗法在其治疗中的应用[J]. 医学研究与教育, 2024, 41(4): 8-14.

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