摘要
目的探讨初次人工髋关节置换术后假体周围感染危险因素并进一步分析预测效能,旨在为临床防治工作提供更多参考信息。方法回顾性纳入2020年1月至2023年1月于邓州市中心医院行初次人工髋关节置换术治疗患者共86例,根据术后随访1年是否发生假体周围感染分为感染组(12例)和未感染组(74例);采用单因素和多因素法评估初次人工髋关节置换术后假体周围感染独立危险因素,进一步评估上述危险因素用于初次人工髋关节置换术后假体周围感染风险预测临床效能。结果单因素分析结果显示,体重指数、合并糖尿病比例、髋关节置换原因、假体类型、手术时间及术中出血量均可能与初次人工髋关节置换术后假体周围感染有关(P<0.05);Logistic回归模型多因素分析结果显示,手术时间超过120 min、合并糖尿病及髋关节肿瘤均是初次人工髋关节置换术后假体周围感染独立危险因素(P<0.05);受试者操作特征(ROC)曲线分析结果显示,手术时间、合并糖尿病及髋关节肿瘤均可用于初次人工髋关节置换术后假体周围感染风险预测,同时三者联合预测曲线下面积(AUC)为0.89(95%CI:0.84~0.96),灵敏度和特异度分别为88.56%,86.29%,预测效能优于单一危险因素(P<0.05)。结论初次人工髋关节置换术后假体周围感染可能与手术时间、有无合并糖尿病及髋关节置换原因有关;而以上三种指标联合用于术后假体周围感染风险预测显示出良好临床效能。
【Objective】To investigate the risk factors and further analyze the predictive efficacy aims to provide more reference information for clinical prevention and treatment.【Methods】Eighty-six patients who underwent initial artificial hip arthroplasty in Dengzhou Central Hospital from January 2020 to January 2023 were retrospectively included.They were divided into infected group(12 cases)and uninfected group(74 cases)according to whether periprosthesis infection occurred during 1-year follow-up.The independent risk factors for periprosthesis infection after primary hip arthroplasty were evaluated by single factor and multifactor methods to further evaluate the clinical efficacy of these risk factors in predicting the risk of periprosthesis infection after primary hip arthroplasty.【Results】The results of univariate analysis showed that body mass index,the proportion of diabetes mellitus,the cause of hip replacement,the type of prosthesis,the time of operation and the amount of blood loss during hip replacement may be related to periprosthesis infection after primary hip replacement(P<0.05).Multivariate analysis of logistic regression model showed that the operative time of more than 120 minutes,diabetes mellitus and hip tumor were independent risk factors for periprosthesis infection after primary hip replacement(P<0.05).Reciever operating characteristic(ROC)curve analysis showed that operative time,diabetes combined with hip tumor could all be used to predict the risk of periprosthesis infection after primary hip replacement,and the area under the curve(AUC)of combined prediction was 0.89(95%CI:0.84 to 0.96),the sensitivity and specificity were 88.56%and 86.29%,respectively,and the prediction efficiency was significantly better than that of single risk factor(P<0.05).【Conclusion】Periprosthesis infection after primary hip arthroplasty may be related to operation time,diabetes mellitus and hip arthroplasty.The combined use of the above three indicators to predict the risk of postoperative periprosthesis
作者
赵博
李吉
张仲凡
ZHAO Bo;LI Ji;ZHANG Zhongfan(Orthopedics Department No.1 Ward,Dengzhou Central Hospital,Dengzhou,Henan 474150,China)
出处
《中国医学工程》
2024年第10期60-63,共4页
China Medical Engineering
关键词
人工髋关节置换术
假体
感染
危险因素
预测
artificial hip replacement
prosthesis
infection
risk factors
forecast
