膝关节注射治疗的频次、药物及医院等级对注射后膝关节感染率的影响  

Effects of frequency of knee joint injection therapy, drugs and hospital level on infection rate of knee joint after injection

作　　者：徐驰[1] 倪明[1] 张庆猛[1] 李恒[1] 张振东[1] 李睿[1] 李昕[1] 陈继营[1] 

机构地区：[1]解放军总医院骨关节科,北京100853

出　　处：《解放军医学院学报》2016年第2期109-111,共3页Academic Journal of Chinese PLA Medical School

基　　金：北京市科技新星与领军人才培养项目(Z1511000003150135)~~

摘　　要：目的分析膝关节注射治疗的注射频次、药物及治疗医院等级对注射后膝关节感染率的影响。方法收集2014年1月-2015年4月我院收治的预行关节置换术且有膝关节腔注射史患者121例,其中男58例,女63例,平均年龄(65±11)岁。根据急性化脓性关节感染诊断标准和假体周围感染国际共识,25例诊断为关节感染,设为感染组,其余96例设为对照组。比较组间关节注射频次、注射药物(玻璃酸钠/糖皮质激素)及注射医院等级(三甲医院/非三甲医院)等因素。结果感染组和对照组关节腔注射频次分别为(4.6±2.2)次和(4.1±2.4)次,组间关节腔注射频次的差异无统计学意义(P>0.05);感染组和对照组中分别有60%和34.4%的患者行糖皮质激素治疗,两组关节腔注射的药物有统计学差异(P<0.05);感染组和对照组分别有92%和66.7%的患者在非三甲医院行关节腔注射治疗,两组关节腔注射医院的等级有统计学差异(P<0.05)。结论关节腔注射糖皮质激素和非三甲医院行关节腔注射均可增加注射后感染风险,但注射频次的增加不会引起注射后感染风险的增加。Objective To analyze the effects of frequency of knee joint injection therapy, drugs and hospitals on infection rate of knee joint after injection. Methods A total of 121 patients with mean age of（65±11） years（58 males and 63 females） had intra-articular injections within 1 year prior to the hospitalization（from January 2014 to April 2015） in Chinese PLA General hospital. Based on the diagnostic criteria of septic arthritis, 121 patients were divided into infection group（n=25） and control group（n=96）. The differences in frequency, drugs（hyaluronic acid or glucocorticoid） and hospitals（grade A tertiary hospital or not） of previous intra-articular injections between two groups were compared. Results Intra-articular injection times of infection group and control group were（4.6±2.2） and（4.1±2.4） with no statistically significant difference（P〉0.05）. The proportion of patients undergoing glucocorticoid therapy in infection group and control group were 60% and 34.4% with significant differences in intra-articular injection drugs between two groups（P〈0.05）. The proportion of patients undergoing intra-articular injection in non-grade A tertiary hospital in infection group and control group were 92% and 66.7% with significant difference in hospital level（P〈0.05）. Conclusion Intraarticular injection with glucocorticoid and injections in non-grade A tertiary hospital are associated with a significant increase in septic arthritis after injections, while the increase of injection times does not lead to an increase in septic arthritis.

关 键 词：关节炎 感染性 注射 关节内 医源性感染 

分 类 号：R684[医药卫生—骨科学]