摘要
目的 总结1例左膝关节置换术后感染合并2型糖尿病患者的多学科团队协作（MDT）联合互联网+延续性护理经验。方法 组建由骨科、内分泌科、伤口造口师等7人构成的MDT团队，围术期实施个体化胰岛素降糖、两次负压封闭引流技术（VSD）病灶清除术护理、万古霉素抗感染及营养支持，出院后依托微信平台与小程序开展为期3个月的互联网+延续性护理。结果 患者创面完全愈合，空腹血糖由17.3 mmol/L降至6.9 mmol/L，血清白蛋白由23.6 g/L升至35.2 g/L。出院随访3个月，HSS膝关节评分由67分提升至92分，日常生活活动能力（ADL）评分由70分提升至95分，未发生二次感染或深静脉血栓。结论 MDT联合互联网+延续性护理可有效整合专科资源，显著改善复杂感染患者的预后。
关键词： 多学科团队；互联网+延续性护理；膝关节置换术；术后感染；糖尿病
Abstract
Objective The aim was to summarize the experience of multidisciplinary team collaboration (MDT) combined with internet-based and continuous care for a patient with left knee joint replacement surgery and type 2 diabetes. Methods An MDT team consisting of 7 members from the orthopedics department, endocrinology department, and wound and ostomy technicians was formed. During the perioperative period, individualized insulin hypoglycemic treatment, two Vacuum Sealing Drainage (VSD) lesion debridement surgeries, vancomycin anti-infection, and nutritional support were implemented. After discharge, internet-based and continuous care was carried out through the WeChat platform and mini-program for a period of 3 months. Results The patient’s wound healed completely, fasting blood glucose decreased from 17.3 mmol/L to 6.9 mmol/L, and serum albumin increased from 23.6 g/L to 35.2 g/L. During the 3-month follow-up after discharge, the HSS knee joint score increased from 67 points to 92 points, the Activities of Daily Living (ADL) score increased from 70 points to 95 points, and no secondary infection or deep vein thrombosis occurred. Conclusion MDT combined with internet-based and continuous care can effectively integrate specialized resources and significantly improve the prognosis of patients with complex infections.
Key words： Multidisciplinary team; Internet-based continuity care; Knee arthroplasty; Postoperative infection; Diabetes
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