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題名 | Delayed-Onset of Pseudomonas Infection in a Hydroxyapatite Orbital Implant: A Case Report=遲發性綠膿桿菌感染珊瑚球義眼:一病例報告 |
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作者 | 葉龍坤; 高淑卿; 蔡傑智; 許紋銘; 劉榮宏; Yeh, Lung-kun; Kao, Shu-ching; Tsai, Chieh-chih; Hsu, Wen-ming; Liu, Jorn-hon; |
期刊 | 中華醫學雜誌 |
出版日期 | 19991100 |
卷期 | 62:11 1999.11[民88.11] |
頁次 | 頁832-837 |
分類號 | 416.74 |
語文 | eng |
關鍵詞 | 全眼球摘除; 眼球內容剜除術; 氫氧磷灰石眼窩植入物; 綠膿桿菌; Enucleation; Evisceration; Hydroxyapatite orbital implant; Pseudomonas aeruginosa; |
中文摘要 | 整體性氫氧磷灰石眼窩植入物(俗稱珊瑚球)是一種多孔性類似珊瑚組織的眼窩植入物,常用於全眼球摘除或眼球內容剜除術後眼窩的重建。由於其具有無數互相連通之小孔,可使纖維及血管長入,理論上可阻止感染或在感染後易於治療。珊瑚球義眼遭受感染的病例報告很少見,且絕大部分的病例均發生在初期纖維血管完全長入之前。 我們報告臺灣首個在接受義眼植入5年後,發生罕見的綠膿桿菌感染的病例。該病患在經過抗生素及眼藥治療後,仍無法完全根治,最後只得摘除植入物,並藉由切片來探討珊瑚球組織的病理變化。由於珊瑚球內有無數的小洞及空腔,一旦遭受感染,情況會變得很嚴重且不易控制,故摘除植入物是唯一成功的治療方法。 |
英文摘要 | Hydroxyapatite(HA) orbital implant, a multiple porous coralloid-like material, is frequently used in orbital reconstruction after enucleation or evisceration surgery. HA implants contain multiple interconnected pores in which rich fibrovascular tissue ingrowth could theoretically help to resist infection. Infection of hydroxyapatite implants are rare. Most HA implant infections occur before complete vascularization. We present this first case in Taiwan of delayed-onset Pseudomonas infection five years after receiving the HA implant. There was not much improvement after intensive medications, so removal of the implant was finally performed. The pathology study disclosed diffuse inflammatory cell infiltration in the whole implant with a necrotic central core. Rich fibrovascular ingrowth was also noted. Once a porous HA implant is infected, the infection is difficult to control and becomes more severe due to the dead space of the interconnected pores. Removal of the implant seems to be the only successful treatment modality. |
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