老年患者关节假体周围感染的危险因素及预防对策

Risk factors of infections around joint prosthesis of elderly patients and prevention countermeasures

目的探讨老年患者关节假体周围感染的危险因素,并提出预防对策,以降低感染率。方法选取2007年11月-2012年11月380例老年行关节置换术患者资料进行回顾性分析,对其假体周围感染情况进行危险因素分析。结果高龄(>70岁)、≥2种并发症、长期使用免疫抑制剂、手术时间>4h、抗菌药物使用不规范、无菌操作不规范、高血糖是关节假体周围感染的危险因素(P<0.05);其中年龄、≥2种并发症、无菌操作不规范是感染的危险因素(P<0.05)。结论老年关节假体应早期接受正规内科规范治疗,术前积极控制合并症,术中严格无菌操作,尽可能地降低人为因素造成的关节假体周围感染的发生。

OBJECTIVE To explore the risk factors of the infections around the joint prosthesis of the elderly patients in Laiwu area and put forward the prevention countermeasures so as to reduce the infection rate.METHODS A total of 380 cases of elderly patients,who underwent the athroplasty in Laiwu area from Nov 2007 to Nov 2012,were enrolled in the study,and the clinical data of the patients were retrospectively analyzed,then the risk factors of the infections around the joint prosthesis were analyzed.RESULTS The more than 70 years of age,more than two types of complications,long term use of immune inhibitors,operation duration more than four hours,unreasonable use of antibiotics,irrational aseptic operation,and high blood glucose were the risk factors of the infections around the joint prosthesis（P0.05）,among which the age,more than two types of complications,and irrational aseptic operation were the high risk factors of the infections.（P0.05）.CONCLUSION To receive the standard internal medicine treatment in the early stage,actively control the complication before the surgery,and rigidly perform the aseptic operation can contribute to the reduction of infections around the joint prosthesis due to human factors.