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目的 设计制作兔人工股骨头置换后感染模型 ,探讨万古霉素 -聚甲基丙烯酸甲酯(VCM -PMMA)在感染预防中的作用。 方法 设计制作兔人工股骨头 ,对 48只日本大耳白兔行人工股骨头置换 ,随机分为 4组 :对照 1组以普通PMMA固定假体 ,VCM1组以VCM -PMMA固定假体 ,即刻接种 1× 10 6 CFU的耐甲氧西林表皮葡萄球菌 (MRSE)SAL65 164。对照 2组和VCM2组分别以普通PMMA和VCM -PMMA固定假体并接种 1× 10 8CFU的MRSE。检测X线片、细菌培养、组织学变化以及C -反应蛋白 (CRP)和血沉 (ESR)的变化。 结果 术后 4周 ,X线片示感染的关节间隙粗糙 ;对照 1组 75 .0 % ( 9/12 )、VCM1组 2 5 .0 % ( 3 /12 )、对照 2组 10 0 .0 % ( 12 /12 )、VCM2组 2 5 .0 %( 3 /12 )感染 ;血清CRP术后第 3天达高峰 ,ESR术后第 7天达高峰。 结论 兔人工股骨头置换后1× 10 8CFU的MRSESAL65 164即刻接种 ,可成功建立兔人工股骨头置换后感染模型 ;VCM -PMMA能有效预防感染发生
Objective To design and manufacture a rabbit model of artificial femoral head replacement to investigate the role of vancomycin-polymethyl methacrylate (PMM-PMMA) in the prevention of infection. Methods Rabbit artificial femoral heads were designed and manufactured. Forty-eight Japanese white rabbits were treated with artificial femoral head replacement. The rabbits were randomly divided into 4 groups: control group 1 received ordinary PMMA fixed prosthesis, VCM1 treated with VCM-PMMA fixed prosthesis, then inoculated immediately 1 × 10 6 CFU of methicillin resistant Staphylococcus epidermidis (MRSE) SAL65 164. Control 2 and VCM2 groups were fixed with normal PMMA and VCM-PMMA, respectively, and inoculated with 1 × 10 8 CFU of MRSE. X-ray films, bacterial cultures, histological changes, and changes in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were examined. Results In the control group 1, 75.0% (9/12), 25.0% (3/12) of the VCM1 group, and 10.0% of the control group 2 (12/12) and 25.0% (3/12) in VCM2 group. Serum CRP peaked on the third day and peaked on the seventh day after ESR. Conclusion Rabbit artificial femoral head replacement MRSESAL65 164 with 1 × 10 8 CFU immediately after inoculation can be successfully established rabbit artificial femoral head replacement infection model; VCM-PMMA can effectively prevent infection