人工髋关节置换术后感染的危险因素与预防  

Risk factors for postoperative infections in patients undergoing total hip arthroplasty and prevention

作　　者：杜英勋 吴汝平[2] 闫青[3] 周方伦 

机构地区：[1]东阳市人民医院骨科,浙江东阳322100 [2]义乌市中心医院骨二科,浙江义乌322000 [3]华中科技大学同济医学院附属普爱医院外科,湖北武汉430033

出　　处：《中华医院感染学杂志》2015年第9期2094-2096,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅科研基金资助项目(11765218)

摘　　要：目的探讨人工髋关节置换术后感染的危险因素,提出有效的预防对策,为早期预防和控制人工髋关节置换术后感染提供依据。方法回顾性分析2004年1月-2012年12月在医院行人工髋关节置换术的992例患者临床资料,将发生感染的15例患者作为研究组,未发生感染的977例患者作为对照组,对比两组患者的临床资料,分析人工髋关节置换术后感染的危险因素及预防对策。结果 992例患者人工髋关节置换术后共发生感染15例,感染率为1.51%;检出病原菌15株,排前5位病原菌依次为金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌、表皮葡萄球菌、肺炎克雷伯菌,分别占33.33%、20.00%、20.00%、13.33%、6.67%;患者年龄、有基础疾病、合并糖尿病、有激素长期应用史、术前血清白蛋白及血红蛋白含量低、手术时间及引流时间是人工髋关节置换术后感染的危险因素(P<0.05)。结论人工髋关节置换术后感染的原因较多,与患者高龄、激素的长期应用、合并多种内科基础疾病等因素有关,根据高危因素有针对性的采取相应的预防对策,可降低感染发生率。OBJECTIVE To explore the risk factors for postoperative infections in patients undergoing total hip ar‐throplasty and put forward effective prevention countermeasures so as to provide guidance for early prevention and control of the postoperative infections .METHODS The clinical data of 992 patients who underwent the total hip arthroplasty from Jan 2004 to Dec 2012 were retrospectively analyzed;15 patients with infections were assigned as the study group ,and 977 patients without infections were set as the control group;the clinical data were compared between the two groups ,the risk factors for the postoperative infections in the patients undergoing the total hip arthroplasty were analyzed , and the prevention countermeasures were put forward .RESULTS The infections occurred in 15 of 992 patients after the total hip arthroplasty ,with the infection rate of 1 .51% .A total of 15 strains of pathogens have been isolated ,among which the Staphylococcus aureus ,Pseudomonas aeruginosa ,Esch‐erichia coli ,Staphylococcus epidermidis ,and K lebsiella pneumoniae ranked the top five species ,accounting for 33 .33% ,20 .00% ,20 .00% ,13 .33% ,and 6 .67% ,respectively .The risk factors for postoperative infections in the patients undergoing total hip arthroplasty included the age ,underlying disease ,history of long term use of hormones ,low contents of preoperative serum albumin and hemoglobin ,operaiton duration ,and drainage time （P〈0 .05） .CONCLUSION There are a variety of risk factors for the postoperative infections in the patients under‐going the total hip arthroplasty ,including the advanced age ,long term use of hormones ,and complication with multiple internal medicine underlying diseases .It is necessary to take targeted prevention countermeasures based on the high risk factors so as to reduce the incidence of infections .

关 键 词：人工髋关节置换术 感染 危险因素 预防对策 

分 类 号：R619.3[医药卫生—外科学]