人工髋关节置换后发热的相关因素分析  

Analysis on relative factors affecting pyrexia following total hip replacement

作　　者：陈登[1] 张亚鑫 戴纪杭 陈铎允 孙钰[2] Chen Deng;Zhang Yaxin;Dai Jihang;Chen Duoyun;Sun Yu(Dalian Medical University,Dalian 116044,Liaoning Province,China;Department of Joint Surgery,Northern Jiangsu People’s Hospital,Yangzhou 225001,Jiangsu Province,China)

机构地区：[1]大连医科大学,辽宁省大连市116044 [2]江苏省苏北人民医院关节外科,江苏省扬州市225001

出　　处：《中国组织工程研究》2021年第18期2846-2850,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:人工髋关节置换后发热一直是困扰骨科医生的难题。目的:分析人工髋关节置换后发热的相关因素。方法:收集苏北人民医院2018年6月至2019年12月行髋关节置换的140例股骨颈骨折患者的病历资料,医院常规测量患者腋温,术后发热定义为>38℃。回顾性分析术后发热与术前、术中及术后因素的关系,其中术前因素有年龄、性别、高血压、糖尿病、体质量指数、术前血红蛋白水平、术前白细胞水平、术前白蛋白水平、术前C-反应蛋白水平、术前是否服用非类固醇抗炎药、术前是否雾化;术中因素有麻醉方式、手术时间、手术出血量;术后因素有术后导尿、术后输血、术后第1天血红蛋白水平、术后第1天白细胞水平、术后第1天白蛋白水平、术后第1天C-反应蛋白水平。结果与结论:①根据术后是否发热分为2组,无发热组100例,发热组40例;②单因素分析结果显示,计量资料中,无发热组患者年龄高于发热组,手术时间短于发热组,术后第1天C-反应蛋白水平低于发热组,差异均有显著性意义(P<0.05);计数资料中,无发热组与发热组在术中麻醉方式、术后第1天白蛋白水平上差异有显著性意义(P<0.05);③将有统计学意义的单因素进行多因素二元Logistic回归分析,发现有4个独立因素与髋关节置换术后发热密切相关,其中手术时间(OR=1.024,P=0.032)、术后第1天C-反应蛋白(OR=1.014,P=0.045)、术中麻醉方式(OR=3.303,P=0.035)为危险因素,术后第1天白蛋白水平(OR=0.337,P=0.045)为保护性因素;④提示人工髋关节置换后发热与手术时间、术中麻醉方式、术后第1天C-反应蛋白水平及术后第1天白蛋白水平明显相关。BACKGROUND: Postoperative pyrexia has also been a problem for orthopedic surgeons. OBJECTIVE: To analyze the related factors of pyrexia after total hip replacement.METHODS: The medical records of 140 patients undergoing hip replacement from June 2018 to December 2019 in Northern Jiangsu People’s Hospital were collected. The body temperature of all patients measured routinely in the hospital was axillary temperature, and postoperative fever was defined as temperature > 38 ℃. The relationship between postoperative pyrexia and preoperative, intraoperative and postoperative factors was retrospectively analyzed. Among them, preoperative factors are: age, sex, hypertension, diabetes, body mass index, preoperative hemoglobin, preoperative leukocytes, preoperative albumin, preoperative C-reactive protein, whether to take nonsteroidal anti-inflammatory drugs before surgery, whether it was nebulized before surgery;intraoperative factors: anesthesia method, operation time, and bleeding volume;postoperative factors: postoperative catheterization, postoperative blood transfusion, hemoglobin on the first day after surgery, leukocytes on the first day after surgery, albumin on the first day and C-reactive protein on the first postoperative day.RESULTS AND CONCLUSION:(1) According to whether there was fever after operation, it was divided into non-pyrexia group(n=100) and pyrexia group(n=40).(2) Univariate analysis results: In the measurement data, the age of non-pyrexia group was higher than that of pyrexia group;the operation time of non-pyrexia group was shorter than that of pyrexia group;and the C-reactive protein of non-pyrexia group was lower than that of pyrexia group on the first day after surgery, and the difference was statistically significant(P < 0.05). In the count data, there were statistical differences between non-pyrexia and pyrexia groups in intraoperative anesthesia and albumin level on the first postoperative day(P < 0.05).(3) The statistically significant single factor was analyzed by multivariate binary

关 键 词：骨折 股骨颈 髋关节置换 术后发热 麻醉 白蛋白 C-反应蛋白 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]