肿瘤型假体治疗骨肉瘤术后假体周围感染的危险因素  

Risk factors of peri-prosthetic infection after treatment of osteosarcoma by tumor-type prosthesis

作　　者：苏晓媛 贾艳[1] SU Xiaoyuan;JIA Yan(Department of Orthopedics,Jiangsu Provincial People’s Hospital,Nanjing 210000,China)

机构地区：[1]江苏省人民医院骨科,南京210000

出　　处：《临床与病理杂志》2021年第10期2294-2298,共5页Journal of Clinical and Pathological Research

摘　　要：目的:探究肿瘤型假体治疗骨肉瘤术后假体周围感染的危险因素。方法:回顾性分析2015年8月至2020年8月江苏省人民医院收治的接受肿瘤假体治疗的223例骨肉瘤患者,根据术后感染情况,将感染者纳入观察组,未感染者纳入对照组。收集并比较两组基线资料、围手术期指标及预后情况,总结导致术后假体周围感染的相关危险因素,探讨其对患者生存预后的影响。结果:术后25例出现假体周围感染,感染率为11.21%,其中10例关节液细菌培养显示阳性,8例术中冰冻显示阳性。术前中性粒细胞及白细胞水平低、手术时间较长、术后接受放射治疗均是导致假体周围感染的高风险因素(P<0.05)。死亡患者中,出现假体周围感染者生存时间更长(P<0.05)。结论:对于行假体治疗的骨肉瘤患者而言,术前中性粒细胞及白细胞水平低、手术时间较长、术后放射治疗均是导致出现假体周围感染的高风险因素,临床上需采取多种方法预防感染。Objective:To explore the risk factors of prosthetic infection around the prosthesis after the treatment of osteosarcoma.Methods:A retrospective analysis of 223 patients with osteosarcoma treated with tumor prosthesis in our hospital from August 2015 to August 2020 was performed.According to the postoperative infection,the infected patients were included in the observation group,and the uninfected patients were included in the control group.The baseline data,perioperative indicators and prognosis of the two groups were collected for comparative analysis.The related risk factors that lead to postoperative infection around the prosthesis are summarized,and its impact on the survival and prognosis of patients is examined.Results:Among the 223 patients with osteosarcoma who underwent prosthesis treatment,25 cases of prosthetic infection occurred after surgery,the incidence rate was 11.21%,of which 10 cases of synovial fluid showed positive bacterial culture,and 8 cases showed positive intraoperative freezing.Low levels of neutrophils and white blood cells before operation,longer operation time,and postoperative radiotherapy are all high-risk factors leading to infection around the prosthesis(P<0.05).Among the dead patients,those with infection around the prosthesis had a longer survival time(P<0.05).Conclusion:For patients with osteosarcoma undergoing prosthetic treatment,low levels of neutrophils and white blood cells before surgery,longer operation time,and postoperative radiotherapy are all high-risk factors leading to infection around the prosthesis,and a variety of clinical measures need to be taken to prevent infection.

关 键 词：肿瘤假体 骨肉瘤 假体周围感染 危险因素 

分 类 号：R738.1[医药卫生—肿瘤]