体质量指数对全膝关节置换患者假体周围感染的影响  

Effect of body mass index on perioperative infection in patients with knee replacement

作　　者：贾瑞平[1] Jia Ruiping(The Third Department of Orthopaedics,Xinxiang Central Hospital,Xinxiang 453000,China)

机构地区：[1]新乡市中心医院骨三科,河南新乡453000

出　　处：《河南医学研究》2018年第22期4049-4051,共3页Henan Medical Research

摘　　要：目的探讨体质量指数(BMI)对全膝关节置换(TKA)患者假体周围感染的影响。方法选取2011年2月至2016年2月在新乡市中心医院接受TKA治疗的3 126例患者。按照BMI分为低体质量组(BMI <18. 5 kg/m^2,318例)、正常体质量组(BMI≥18. 5 kg/m^2且<24 kg/m^2,1 370例)、超体质量组(BMI≥24 kg/m^2且<28 kg/m^2,1 032例)和肥胖组(BMI≥28 kg/m^2,406例)。采集患者年龄、性别、BMI、病程、合并疾病、左右膝构成、手术时间、术中出血量、术后引流时间等资料。结果低体质量组、正常体质量组、超体质量组和肥胖组在性别、年龄、病程、左右膝构成方面比较,差异无统计学意义(P> 0. 05)。随着BMI增高,手术时间、术中出血量和术后引流时间增加,4组间比较差异有统计学意义(P <0. 05)。3 126例接受TKA治疗的患者中发生假体周围感染者46例,感染率为1. 41%(46/3 126)。低体质量组、正常体质量组、超体质量组和肥胖组假体周围感染发生率分别为3. 46%(11/318)、0. 58%(8/1 370)、1. 16%(12/1 032)和3. 69%(15/406),低体质量组和肥胖组假体周围感染发生率高于正常体质量组,差异有统计学意义(P <0. 05)。Logistic回归分析结果显示,BMI、糖尿病、手术时间和术后引流时间是TKA患者假体周围感染的高危因素(P <0. 05)。结论 BMI异常是导致TKA患者术后假体周围感染的独立危险因素。Objective To investigate the effect of body mass index(BMI)on periprosthetic infection in patients with TKA.Methods A total of 3 126 patients with total knee arthroplasty(TKA)who were treated in Xinxiang Central Hospital from February of 2011 to February of 2016 were selected.According to BMI,patients were divided into low body mass group(BMI<18.5 kg/m 2,318 cases),normal body mass group(BMI<18.5 kg/m 2,318 cases),overweight group(BMI≥24 kg/m 2 and<28 kg/m 2,1 032 cases)and obesity group(BMI≥28 kg/m 2,406 cases).Age,Gender,BMI,duration,combined disease,left and right knee composition,operation time,intraoperative blood loss,postoperative drainage time and other information were collected.Results There were no significant differences in gender,age,course of disease,left and right knee composition in low body mass group,normal body mass group,overweight group and obesity group(P>0.05).With the increase of BMI,the operation time,intraoperative blood loss and postoperative drainage time increased,and the differences between the four groups were statistically significant(P<0.05).Of the 3 126 patients who received TKA,46 had periprosthetic infection,and the infection rate was 1.41%(46/3 126).The incidences of periprosthetic infection were respectively 3.46%(11/318),0.58%(8/1 370),1.16%(12/1 032)and 3.69%(15/406)in low body mass group,normal body mass group,overweight group and obesity group.The incidences of periprosthetic infection in low body mass group and overweight group were significantly higher than that of normal body mass group,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that BMI,diabetes mellitus,operation time and postoperative drainage time were the high risk factors of TKA in patients with perioperative infection(P<0.05).Conclusion BMI abnormality is the independent risk factor for periprosthetic infection after operation in TKA patients.

关 键 词：膝关节置换 假体周围感染 体质量指数 肥胖 

分 类 号：R658.3[医药卫生—外科学]