人工关节置换术后感染高危因素的研究现状  

Research status of high-risk factors of infection after artificial joint replacement

作　　者：刘子歌 宋国瑞 张晨 陈德胜[2] LIU Zi-ge;SONG Guo-rui;ZHANG Chen;CHEN De-sheng(School of Clinical Medicine,Ningxia Medical University,Yinchuan 750004,China;Department of Orthopedics,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学临床医学院,宁夏银川750004 [2]宁夏医科大学总医院骨科,宁夏银川750004

出　　处：《中国当代医药》2019年第31期17-20,26,共5页China Modern Medicine

基　　金：国家自然科学基金项目(81560364、81760395、81760405);宁夏医科大学重点项目(XZ2018014)

摘　　要：人工关节假体感染(PJI)是人工关节置换术后最棘手也是最常见的灾难性并发症之一。随着我国逐渐步入人口老龄化社会,人工关节假体置换术所导致的PJI相应增加。临床上,引起人工关节置换术后感染的主要高危因素分为两大类:糖尿病、术前营养不良、病态肥胖、吸烟饮酒史、术前贫血、药物使用等与患者自身并发症状有关的,称为不可改变因素;术前关节穿刺、鼻腔定植金葡菌、无症状性菌尿、手术时间长等潜在危险因素可在术前进行预先处理和术中控制的,称为可改变因素。因此,尽可能地总结与完善PJI的高危因素并积极采取预防措施,对预防该疾病的发生至关重要。本文就常见的人工关节置换术后高危感染因素进行分类并作一综述,以期为预防和治疗PJI提供理论依据。Artificial prosthesis joint infection(PJI)is one of the most intractable and most common catastrophic complications after artificial joint replacement.As China gradually enters an aging society,the PJI caused by artificial joint prosthesis replacement increases accordingly.Clinically,the main high-risk factors for postoperative infection after artificial joint replacement are divided into two categories:diabetes,preoperative malnutrition,morbid obesity,smoking and drinking history,preoperative anemia,drug use,etc.,which are related to the patients′own complications,are called non-modifiable factors;preoperative joint puncture,nasal colonization of Staphylococcus aureus,asymptomatic bacteriuria,long operation time and other potential risk factors which can be pre-treated and intraoperatively controlled before surgery,are called modifiable factors.Therefore,it is important to summarize and improve the risk factors of PJI and take preventive measures as much as possible to prevent the occurrence of this disease.This article reviews the common high-risk infection factors after artificial joint replacement,so as to provide a theoretical basis for the prevention and treatment of PJI.

关 键 词：人工关节置换术 关节假体感染 高危因素 并发症 

分 类 号：R687.4[医药卫生—骨科学]