摘要
目的探讨初次人工全膝关节置换后假体周围感染的危险因素,为预防假体周围感染提供参考。方法回顾分析大理大学第一附属医院2012年1月—2019年1月初次单侧人工全膝关节置换术后并发假体周围感染的患者资料,共21例作为感染组,随机选取同期于该院行人工全膝关节置换无感染患者84例作为对照组。对两组患者个人因素、手术因素、术后因素进行单因素分析,比较两组患者感染危险因素的差异。根据单因素分析结果,对有统计学意义的感染危险因素再进行二元logistic回归分析。结果本研究初次人工全膝关节置换术后假体周围感染发生率为2.4%。二元logistic回归分析发现,手术时间、关节腔穿刺注射史、术前3个月口服激素史、尿沉渣细菌阳性为人工全膝关节置换术后假体周围感染的独立危险因素。21例感染患者标本细菌培养分离细菌14株,革兰阳性菌7株(50.0%),革兰阴性菌6株(42.9%),真菌1株(7.1%)。结论手术时间长、术前有关节腔穿刺注射史、术前3个月口服激素、尿沉渣细菌阳性患者术后发生假体周围感染风险较高,可以为临床预防感染提供参考。
Objective To investigate the risk factors of periprosthetic infection after primary total knee arthroplasty and analyze the causes of infection for better prevention of periprosthetic infection.Methods The data of 21 patients with periprosthetic infection after primary unilateral total knee arthroplasty in the First Affiliated Hospital of Dali University from January 2012 to January 2019 were retrospectively analyzed.Another 84 patients who underwent total knee arthroplasty without infection during the same period were randomly selected as the non-infection controls.Univariate analysis was conducted for demographic factors,surgical factors,and postoperative factors to compare the differences in risk factors of infection between the two groups.The significant risk factors of infection derived from univariate analysis were analyzed by binary logistic regression.Results The incidence of periprosthetic infection after primary total knee arthroplasty was 2.4%.Binary logistic regression analysis showed that operative time,history of intra-articular injection,oral steroid therapy within 3 months before surgery,and positive bacteria in urinary sediment were independent risk factors for periprosthetic infection after total knee arthroplasty.Microbiological culture identified 14 strains of pathogens,including 7 strains(50.0%)of gram-positive bacteria,6 strains(42.9%)of gram-negative bacteria,and 1 strain(7.1%)of fungus.Conclusions Longer operation time,preoperative history of intra-articular injection,oral steroid therapy within 3 months before surgery,and positive bacteria in urine sediment are risk factors of periprosthetic infection.Control of these factors may help prevent periprosthetic infection.
作者
孙哲
孙朝军
李红
胡志富
赵昌
许靖
李月
杨爱京
SUN Zhe;SUN Chaojun;LI Hong;HU Zhifu;ZHAO Chang;XU Jing;LI Yue;YANG Aijing(Department of JointSurgery,The First Affiliated Hospital of Dali University,Dali Yunnan 671000,China)
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2021年第5期546-551,共6页
Chinese Journal of Infection and Chemotherapy
关键词
人工关节置换
膝
假体周围感染
危险因素
artificial joint replacement
knee
periprosthetic infection
risk factor
