人工全膝关节置换术后迟发感染病原菌分布及危险因素分析  

Distribution of pathogenic bacteria and risk factors affecting delayed infection after total knee arthroplasty

作　　者：王秀芹[1] 周健[2] 李静静[3] 吕英莲[1] 陈秀丽[1] 

机构地区：[1]潍坊市人民医院医疗部,山东潍坊261041 [2]青岛市市立医院骨科,山东青岛266011 [3]潍坊市中医院急诊科,山东潍坊261041

出　　处：《中华医院感染学杂志》2016年第24期5635-5637,共3页Chinese Journal of Nosocomiology

基　　金：潍坊市卫生科技发展计划基金项目(2014075)

摘　　要：目的探讨人工全膝关节置换术(TKA)后迟发感染病原菌分布及相关危险因素,为临床治疗提供参考依据。方法回顾性分析2010年1月-2015年3月在医院进行TKA 500例患者的临床资料,分析TKA迟发感染的病原菌分布情况及危险因素,数据采用SPSS 20.0软件进行统计分析。结果 500例TKA发生医院感染30例,感染率为6.00%;迟发感染者7例,检出病原菌11株,以革兰阳性菌为主,共6株占54.55%;多因素分析显示,年龄、吸烟、手术时间、合并糖尿病、术后伤口引流不畅均是TKA迟发感染的独立危险因素(P<0.05)。结论TKA术后迟发感染有多种危险因素,医院应该在严格手术室无菌操作的基础上对这些因素进行重点预防,使迟发感染的发生率降至最低。OBJECTIVE To discuss the distribution of pathogenic bacteria and related risk factors affecting delayed infection after total knee arthroplasty（TKA）,so as to provide references for clinical treatment.METHODS The clinical data of 500 cases of patients treated with TKA in our hospital from Jan.2010 to Mar.2015 were retrospectively analyzed.The distribution of pathogenic bacteria and the risk factors of patients with delayed infection were analyzed.The data were analyzed by SPSS 20.0.RESULTS There were 30 cases of patients occurred nosocomial infection in the 500 cases after TKA,with the infection rate of 6.00%,and there were 7cases of patients who happened delayed infection.A total of 11 strains of pathogenic bacteria were detected,and mainly were 6strains of gram-positive bacteria,accounting for 54.55%.The multivariate analysis showed factors such as age,smoking,operation time,diabetes mellitus,and postoperative wound drainage were the independent risk factors for delayed infection after TKA（P〈0.05）.CONCLUSIONThere are many risk factors for delayed infection after TKA,which should be focused on to prevent on the basis of strict aseptic operation in hospital,so as to minimize the incidence of delayed infection.

关 键 词：人工全膝关节置换术 感染 病原菌 危险因素 

分 类 号：R378[医药卫生—病原生物学]