摘要
目的探究股骨头坏死关节置换术后医院感染的临床特点。方法选择2013年8月-2017年6月在医院治疗的单侧股骨头坏死患者473例,对股骨头坏死关节置换术后医院感染患者的标本进行细菌培养分离。分别给予单因素和多因素Logistic回归模型分析。结果 473例股骨头坏死关节置换术后发生23例次感染,例次感染率占4.86%。下呼吸道感染,占47.83%,为主要感染部位;共培养分离出49株病原菌,以革兰阳性菌为主导,33株,占67.35%,革兰阴性菌14株,占28.57%;相关基础疾病≥3种、既往手术史、手术时间>3h、抗菌药物使用≥3种及住院时间≥7d是导致股骨头坏死关节置换术后患者发生医院感染的相关独立影响因素(P<0.05)。结论股骨头坏死关节置换术的患者术后医院感染率相对较高,要依据患者医院感染的病原菌特点及导致感染的危险因素,给予患者合理的预防措施。
OBJECTIVE To explore the clinical characteristics of postoperative nosocomial infections in the femoral head necrosis patients undergoing arthroplasty.METHODS A total of 473 patients with unilateral femoral head necrosis who were treated in the hospital from Aug 2013 to Jun 2017 were enrolled in the study,the specimens that were collected from the patients who had nosocomial infections after the arthroplasty were cultured,and univariate analysis and multivariate logistic regression analysis were performed.RESULTS Of the 473 patients with femoral head necrosis who received the arthroplasty,23 case-times of patients had postoperative infections,with the case-time infection rate 4.86%;the patients with lower respiratory tract infections were dominant among the patients with the postoperative infections,accounting for 47.83%.Totally 49 strains of pathogens were isolated from the patients,33(67.35%)of which were gram-positive bacteria,and 14(28.57%)were gram-negative bacteria.No less than 3 types of underlying diseases,previous surgery history,operation duration more than 3 hours,use of no less than 3 types of antibiotics and length of hospital stay no less than 7 days were the independent influencing factors for the postoperative nosocomial infections in the femoral head necrosis patients undergoing arthroplasty(P<0.05).CONCLUSIONThe incidence of postoperative nosocomial infections is relatively high among the femoral head necrosis patients undergoing arthroplasty,therefore,it is necessary to take appropriate prevention measures according to the etiological characteristics and risk factors for the nosocomial infections.
作者
贺葵
宋如
陈歌
尹一然
刘俊才
HE Kui;SONG Ru;CHEN Ge;YIN Yi-ran;LIU Jun-cai(The Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第6期897-900,共4页
Chinese Journal of Nosocomiology
基金
四川省科技厅基金资助项目(2017FZ0045)
关键词
股骨头坏死
关节置换
感染
病原菌
影响因素
Femoral head necrosis
Arthroplasty
Infection
Pathogen
Influencing factor
