保留假体清创术的效果及其影响因素  

Effect of retained prosthetic debridement and its influencingfactors

作　　者：张富运[1] 李顺国[1] 马伟涛[1] 方加尧 ZHANG Fu-yun;LI Shun-guo;MA Wei-tao;FANG Jia-yao(The Second People's Hospital of Jiaozuo,Jiaozuo,Henan 454001,China)

机构地区：[1]焦作市第二人民医院骨科,河南焦作454001

出　　处：《中华医院感染学杂志》2023年第4期589-592,共4页Chinese Journal of Nosocomiology

摘　　要：目的 比较保留假体清创术在假体周围感染有窦道形成与无窦道形成患者中的成功率,探究保留假体清创术失败的影响因素.方法 回顾性分析2010年1月-2021年1月焦作市第二人民医院26例人工关节置换术后假体周围感染行保留假体清创术的病例,其中有窦道形成的患者10例,无窦道形成患者16例.利用Kaplan-Meier生存分析对比有窦道与无窦道形成患者之间保留假体清创术失败率的差异.利用单因素与Cox多因素回归分析探索保留假体清创术失败的影响因素.结果 26例患者中,共8例患者保留假体清创术失败,其中窦道形成组患者失败3例,无窦道形成组患者失败5例;窦道形成不是保留假体清创术失败的危险因素;Cox回归提示年龄是保留假体清创术失败的危险因素,高龄(>65岁)患者与低龄患者组的失败风险比是20.3.结论 窦道形成与否不影响保留假体清创术的成功率,高龄(特别是患者年龄>65岁)是保留假体清创术失败的高危因素.OBJECTIVE To compare the successful rate of retained prosthetic debridement in patients with periprosthetic infection with and without sinus tract formation,and to investigate the factors influencing failure of retained prosthetic debridement.METHODS Twenty-six cases with retained prosthetic debridement for periprosthetic infection after prosthetic joint replacement in the Second People's Hospital of Jiaozuo City between Jan.2010 and Jan.2021 were retrospectively analyzed,including 10 patients with a sinus tract and 16 patients without sinus tract formation.Kaplan-Meier survival analysis was used to compare the difference in failure rates of retained prosthetic debridement between patients with and without sinus tract formation.Univariate analysis and multivariate Cox regression were performed to identify the potential risk factors for failure of DAIR.RESULTS Of the 26 patients,a total of 8 patients failed retained prosthetic debridement,including 3 patients in the sinus formation group and 5 patients in the no sinus formation group.Sinus formation was not the risk factor for failure of retained prosthetic debridement.Cox regression model indicated that the advanced age was the risk factor for failure of retained prosthetic debridement.Patients with the age>65 had a hazard ratio of 20.3 for failure of retained prosthetic debridement as compared to patients with the age<65.CONCLUSION Sinus tract formation did not influence the successful rate of retained prosthetic debridement,while the advanced age(especially in patients>65 years)was the risk factorfor failureof retained prostheticdebridement.

关 键 词：人工关节置换术 假体周围感染 保留假体清创术 窦道形成 危险因素 

分 类 号：R619.3[医药卫生—外科学]