股骨颈骨折患者关节置换术后继发医院感染的影响因素  

Influencing Factors of Secondary Nosocomial Infection in Patients with Femoral Neck Fracture After Hip Arthroplasty

作　　者：蒋亚 周燕 王艳敏 张龙[2] 司文腾 JIANG Ya;ZHOU Yan;WANG Yanmin;ZHANG Long;SI Wenteng(The First Department of Orthopedics,Henan Second Provincial People’s Hospital,Zhengzhou 451191,China;the First Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]河南省第二人民医院骨一科,河南郑州451191 [2]郑州大学第一附属医院骨一科,河南郑州450000

出　　处：《河南医学研究》2023年第12期2180-2183,共4页Henan Medical Research

基　　金：2019年河南省医学科技攻关计划联合共建项目(LHGJ20191147)。

摘　　要：目的探讨股骨颈骨折(FNF)患者关节置换术(HA)后继发医院感染的危险因素。方法回顾性分析2019年1月至2023年1月在河南省第二人民医院接受关节置换术的165例股骨颈骨折患者,根据是否出现术后继发医院感染将其分为感染组(31例)和未感染组(134例)。无菌采集伤口周围分泌物,进行病原菌分离鉴定;采用logistic回归分析影响FNF患者HA术后继发医院感染的危险因素。结果FNF患者HA术后继发医院感染率为18.79%,分离菌株以金黄色葡萄球菌(36.73%)为主,感染部位主要为呼吸道(38.71%)和手术切口(32.26%);FNF患者HA术后继发医院感染与年龄、合并糖尿病、髋关节手术史、长期使用激素类药物、留置引流管时间有关(P<0.05);logistic回归分析显示,髋关节手术史和合并糖尿病均为影响FNF患者HA术后继发医院感染的独立危险因素(P<0.05)。结论合并糖尿病和髋关节手术史均为影响FNF患者HA术后继发医院感染的独立危险因素,临床应密切关注具备相关危险因素的FNF患者,加强其血糖监测,以降低其术后发生继发医院感染的风险。Objective To explore the risk factors of secondary nosocomial infection in patients with femoral neck fracture(FNF)after hip arthroplasty(HA).Methods A total of 165 patients with FNF undergoing HA in Henan Second Provincial People’s Hospital were retrospectively analyzed from January 2019 and January 2023.According to presence or absence of secondary nosocomial infection after surgery,they were divided into infection group(31 cases)and non-infection group(134 cases).The secretions around wounds were collected aseptically for isolation and identification of pathogens.The risk factors of secondary nosocomial infection were analyzed by logistic regression analysis.Results The incidence of secondary nosocomial infection in FNF patients after HA was 18.79%.The main pathogen was Staphylococcus aureus(36.73%),and main infection sites were respiratory tract(38.71%)and surgical incision(32.26%).Secondary nosocomial infection in patients with FNF after HA was correlated with age,diabetes mellitus,history of hip surgery,long-term use of hormone and indwelling time of drainage tube(P<0.05).Logistic regression analysis showed that history of hip surgery and diabetes mellitus were independent risk factors of secondary nosocomial infection in patients with FNF after HA(P<0.05).Conclusion Diabetes mellitus and history of hip surgery are independent risk factors of secondary nosocomial infection in patients with FNF after HA.Clinical attention should be paid to for FNF patients with the related risk factors,and blood glucose monitoring should be strengthened to reduce the risk of secondary nosocomial infection.

关 键 词：股骨颈骨折 关节置换术 继发医院感染 logistics回归分析 

分 类 号：R683.4[医药卫生—骨科学]