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目的关节假体周围感染（PJI）是目前关节置换术后最严重的并发症。尽管许多标志物在PJI的诊断中取得了良好的效果，但早期的诊断仍然缺乏金标准。本研究旨在探讨凝血相关指标与全关节置换术（TJA）患者术后发生PJI的关系。方法我们进行了一项回顾性队列研究，选取在2011年1月至2022年1月期间接受了髋关节或膝关节置换术的总共2 517例患者（2 394例初次置换，87例无菌翻修，36例PJI）。我们应用多因素logistic回归分析，对比PJI组、初次置换和无菌翻修组之间凝血相关指标的差异。应用观察者操作特性曲线（ROC）和曲线下面积（AUC）来评估凝血相关指标在PJI中的诊断价值。结果本研究纳入的指标包括血浆纤维蛋白原（FBG），凝血酶原时间（PT），凝血酶时间（TT），活化部分凝血活酶时间（APTT），血小板（PLT），平均血小板体积（MPV），血小板分布宽度（PDW），血小板比容（PCT），PLT/MPV，PLT/PDW和PLT/PCT。与其他凝血相关指标相比，FGB水平升高与PJI发生风险密切相关。PJI组与初次置换组相比，FBG的最佳诊断界值为4.53 g/L，诊断敏感性为47.22%，特异性为93.07%；与翻修组比，FBG的最佳诊断界值为4.44 g/L，诊断敏感性为47.22%，特异性为95.40%。ROC曲线分析提示FBG具有中度诊断效能，表明其为PJI诊断的潜在标志物。结论FBG水平与PJI发生风险显著相关，可在临床中作为诊断PJI的重要指标。

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BACKGROUND: The long bone is the recurrent site of metastatic tumors. Broken sclerotin weakens the support strength of long bone, which leads to fracture under external force. Percutaneous osteoplasty can reinforce local bone strength and kill tumor cells. But it cannot fortify the whole long bone enough to avoid fracture occurrence. OBJECTIVE: To compare the efficacy of percutaneous long bone cementoloplasty with and without embedding a cement-filled catheter in the medullary canal for painful long bone metastases with impending fracture. METHODS: Forty-two patients were divided into two groups according to the treatment schedule. Patients in control group were treated with percutaneous osteoplasty combined with bone cement injection and the other patients in experimental group were treated with percutaneous osteoplasty combined with multiholed catheter bone cement injection. Rate of bone cement leakage was statistically analyzed. Visual analogue scale score, Karnofsky function score and number of cases of long bone fracture were detected and compared between the two groups. RESULTS AND CONCLUSION: (1) All the patients completed puncture and bone cement injection. There were seven cases of bone cement leakage in the control group and eight cases of bone cement leakage in the experimental group, and no difference existed in two groups (P > 0.05). (2) The visual analogue scale score and Karnofsky function score in each patient were both improved after treatment (P < 0.05), but there was no difference between the two groups (P > 0.05). (3) Five cases of bone re-fracture were found in the control group, but no case in the experimental group. To conclude, the use of percutaneous osteoplasty combined with multiholed catheter bone cement injection for metastatic tumor-induced impending fracture of the long bone can prevent bone fracture at the lesion site. Subject headings: Fractures; Bone; Fractures; Spontaneous; Neoplasm Metastasis; Tissue Engineering [ABSTRACT FROM AUTHOR]

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