OsteomyelitisOsteomyelitis骨髓炎骨髓炎Osteomyelitisisaninflammationofbonecausedbyaninfectingorganism.Itmayremainlocalized,oritmayspreadthroughthebonetoinvolvethemarrow,cortex,periosteum,andsofttissuesurroundingthebone.化脓性骨髓炎是一种常见病，病因为化脓性细菌感染，它涉及骨膜、骨松质、骨密质与骨髓组织。acutesuppurativeosteomyelitis急性血源性骨髓炎Acutehematogenousosteomyelitisisthemostcommontypeofboneinfectionandiscommonlyseeninchildren.Inchildrenthemetaphysesofrapidlygrowinglongbonesaremostfrequentlyinvolved.Theinfectioncausesaninflammatoryreaction,localischemicnecrosisofthemarrowandthenbone,andsubsequentabscessformation.在急性化脓性骨髓炎中，急性血源性骨髓炎最多见；约80%以上为12岁以下的儿童，男女比例约为4：1。长骨干骺端为好发部位，其中以胫骨上下端，股骨下端及肱骨上端最多见。其他骨骼也可发生，但较少见。Bacteremiaisanalmostdailyeventinchildhood,andotheretiologicalfactors,suchaslocalizedtraumaordebilitationfromachronicillness,malnutrition,orinadequacyoftheimmunesystem,mustbepresentfortheinfectiontodevelop.在急性血源性骨髓炎发病前，身体其他部位常有明显或不明显的感染性病灶，当处理不当或机体抵抗力降低时，感染灶内的致病细菌经血液循环至骨内停留而引起骨组织的急性感染。Astheabscessincreasesinsize,intramedullarypressureincreases;thiscausesmorebonetobecomeischemic,andeventuallypurulentmaterialescapesthroughthecortexintothesubperiostealspaceandformsasubperiostealabscess.Ifinadequatelytreated,thisprocesseventuallyresultsinextensivesequestra.Pathophysiologyofhematogenousseeding.Whenunderpressure,exudateorabscesscanextendthroughVolkmanncanalsintosubperiostealregionandfromthereintomedullarycavityorepiphysis.大量的细菌停滞在长骨的干骺端渗出形成脓肿，并向各方向扩散。Clinicalmanifestation临床表现1）起病急，全身中毒症状重。病人高热，体温常在摄氏39~40度，伴寒战，精神不振，食欲不佳，脉快，小儿惊厥等。2）感染早期，局部剧痛，皮温升高，患肢呈半屈曲制动状。3）脓肿进入骨膜下时，局部明显压痛。当脓肿穿进皮下时，局部红，肿，痛，热明显。4）病情严重者可发生中毒休克，出现多...
