术前结肠清洗对预防髋关节置换术后手术部位感染的有效性研究  

Effectiveness of preoperative colon cleansing in prevention of postoperative surgical site infection in hip arthroplasty patients

作　　者：刘晓晔 王艳[2] 徐枝楼 张春丽[2] 嵇利亚[3] LIU Xiao-ye;WANG Yan;XU Zhi-lou;ZHANG Chun-li;JI Li-ya(Xuzhou Central Hospital,Xuzhou,Jiangsu 221009,China)

机构地区：[1]徐州市中心医院骨科,江苏徐州221009 [2]徐州市中心医院供应中心,江苏徐州221009 [3]徐州市中心医院心内科,江苏徐州221009

出　　处：《中华医院感染学杂志》2020年第10期1541-1545,共5页Chinese Journal of Nosocomiology

基　　金：江苏省卫生计生委科研基金资助项目(BJ180056)。

摘　　要：目的探讨术前结肠清洗对预防髋关节置换术术后手术部位感染的有效性。方法选择2017年4月-2018年4月于徐州市中心医院行髋关节置换术的86例患者,按数字表法随机分为结肠清洁组和对照组,每组43例。两组患者术前均予以常规处理,结肠清洁组另予以术前结肠清洗。比较两组患者术前、术后第1天、第7天感染指标白细胞介素-6 (Interleukin,IL-6)、C-反应蛋白(C-reactive protein,CRP)、降钙素原(Procalcitonin,PCT)、细菌脂多糖(Lipopolysaccharide,LPS)、红细胞沉降率(Erythrocyte sedimentation rate,ESR)及白细胞(WBC)计数的表达水平,随访期间记录两组患者的手术部位感染情况。结果两组患者术前血清IL-6、CRP、PCT、LPS、ESR及WBC计数水平比较无显著差异,术后第1天结肠清洁组患者上述指标均低于对照组(P<0.05);术后第7天,两组患者上述指标均下降,除WBC计数外结肠清洁组其他指标均低于对照组(P<0.05);随访期间,结肠清洁组合并2例浅表感染、而对照组合并3例浅表感染、3例深部感染,3例假体周围感染,两组间感染发生率比较差异具有统计学意义(χ~2=4.074,P=0.044)。结论术前结肠清洗可减低髋关节置换术后手术部位感染的发生率,值得在临床上推广应用。OBJECTIVE To explore the effectiveness of preoperative colon cleansing in prevention of postoperative surgical site infection in hip arthroplasty patients.METHODS A total of 86 patients who underwent hip arthroplasty in Xuzhou Central Hospital from Apr.2017 to Apr.2018 were enrolled in the study and randomly divided into the colon cleansing group and the control group,with 43 cases in each group.The two groups of patients were given conventional treatment before the surgery,and the colon cleansing group was treated with additional preoperative colon cleansing.The levels of infection indexes interleukin(IL-6),C-reactive protein CRP),procalcitonin(PCT),lipopolysaccharide(LPS),erythrocyte sedimentation rate(ESR)and white blood cell(WBC)counts were observed and compared before the surgery and after surgery for 1 and 7 days,and the incidence of surgical site infection in the two groups of patients was recorded during the follow-up.RESULTS There were no significant differences in the levels of serum IL-6,CRP,PCT,LPS,ESR and WBC counts between the two groups of patients before the surgery,the levels of above indexes of the colon cleansing group were significantly lower than those of the control group after the surgery for 1 day(P<0.05);the levels of above indexes of the two groups of patients were reduced after the surgery for 7 days;all of the indexes,except for WBC counts,were lower in the colon cleansing group than in the control group(P<0.05).There were 2 patients who were complicated with superficial infection in the colon cleansing group and 3 patients complicated with superficial infection,3 patients with deep infection and 3 patients with periprosthetic infection in the control group,with significant difference in the incidence of infection between the two groups(χ~2=4.074,P=0.044).CONCLUSION The preoperative colon cleansing may reduce the incidence of postoperative surgical site infection in the hip arthroplasty patients,and it is worthy to be promoted in the hospital.

关 键 词：结肠清洗 髋关节置换术 手术部位感染 有效性 

分 类 号：R687.4[医药卫生—骨科学]