全髋关节置换术后患者感染的影响因素分析  

Influencing factors for postoperative infections in patients undergoing total hip arthroplasty

作　　者：陈小红 翁晓华 王葵儿[2] 

机构地区：[1]浙江绿城心血管病医院外科,浙江杭州310012 [2]杭州市第一人民医院外科,浙江杭州310006

出　　处：《中华医院感染学杂志》2016年第1期131-133,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅基金资助项目(2013KYB202)

摘　　要：目的分析全髋关节置换术(THA)后患者感染的影响因素,提出针对性的干预措施。方法回顾性分析2013年2月-2015年2月在医院接受THA手术的420例患者临床资料,分析术后感染的发生率以及危险因素;采用SPSS19.0软件对数据进行统计分析。结果 420例THA手术患者中共有24例患者术后发生感染,感染率为5.7%;共分离出病原菌28株,其中革兰阳性菌12株占42.9%,革兰阴性菌16株占57.1%;单因素分析显示,年龄>60岁、手术时间>180min、长期应用激素、并发糖尿病、髋关节手术史、血清白蛋白≤35g/L等因素的差异有统计学意义(P<0.05),上述因素为THA术后患者感染发生的危险因素,进一步对上述因素进行多因素logistic回归分析显示,年龄、手术时间、长期应用激素、并发糖尿病、髋关节手术史、血清白蛋白≤35g/L是THA手术后患者发生感染的独立危险因素。结论 THA术后感染病原菌以革兰阴性菌为主,感染的发生与多种因素密切相关,应针对感染的危险因素进行干预,以降低患者的术后感染率。OBJECTIVE To investigate the influencing factors for postoperative infections in the patients undergoing total hip arthroplasty and put forward the targeted intervention strategies.METHODS The clinical data of 420 patients who underwent the total hip arthroplasty from Feb 2013 to Feb 2015 were retrospectively analyzed,the incidence of the postoperative infections and the risk factors were observed,and the statistical analysis of data was performed with the use of SPSS19.0software.RESULTS Of 420 patients undergoing the total hip arthroplasty,24 had the postoperative infections with the infection rate of 5.7%.A total of 28 strains of pathogens were isolated,including 12（42.9%）strains of gram-positive bacteria and 16（57.1%）strains of gram-negative bacteria.The univariate analysis indicated that there was significant difference in the more than 60 years of age,operation duration more than 180 min,long-term use of steroids,complication of diabetic mellitus,history of hip surgery,or serum albumin level no more than 35g/L（P〈0.05）,and the above factors were the risk factors for the postoperative infections in the patients undergoing the total hip arthroplasty.The multivariate logistic regression analysis further showed that the independent risk factors for the infections in the patients undergoing the total hip arthroplasty included the age,operation duration,long-term use of steroids,complication of diabetic mellitus,and history of hip surgery,and serum albumin.CONCLUSIONThe gram-negative bacteria are dominant among the pathogens causing the postoperative infections in the patients undergoing the total hip arthroplasty,and the incidence of the infections is closely associated with multiple factors.It is necessary to take intervention measures aiming at the risk factors for the infections so as to reduce the incidence of the postoperative infections.

关 键 词：全髋关节置换术 术后感染 危险因素 病原菌 干预措施 

分 类 号：R619.3[医药卫生—外科学]