髋关节置换术后假体周围感染临床研究

Clinical research on infections around prosthesis after hip replacement surgery

目的对分析二期翻修术和一期翻修术用于髋关节置换术后假体周围感染的临床效果,为降低术后再次感染提供依据。方法调查2009年2月-2013年11月140例髋关节置换术后假体周围感染患者,采用计算机随机分组的方式将患者分为对照组(一期翻修术)和试验组(二期翻修术),每组各70例,观察其治疗效果,采用SPSS 18.0软件进行数据统计分析。结果试验组患者治愈68例,治愈率97.14%,发生并发症2例,发生率2.86%,对照组患者治愈65例,治愈率92.86%,发生并发症5例,发生率7.14%,两组差异有统计学意义(P<0.05);经过1年的随访,试验组患者在Ganland和Werley评分(缺陷失分)均优于对照组(P<0.05);对照组患者有3例发生不良反应,发生率4.29%,试验组患者无不良反应发生。结论总体显示,二期翻修术的治疗方式较一期翻修术的治疗效果更有优势。

OBJECTIVE To observe the clinical effects of phase II revision surgery and phase I revision surgery on treatment of infections around prosthesis after hip replacement surgery so as to reduce the incidence of postopera‐tive recurrent infections .METHODS A total of 140 patients who underwent the hip replacement surgery from Feb 2009 to Nov 2013 and were complicated with postoperative infections around prosthesis were enrolled in the study , then the participants were randomly divided into the control group （the phase Ⅰ revision surgery ） and the experi‐mental group （the phase Ⅱ revision surgery） by the computer ,the curative effects were observed ,and the statisti‐cal analysis was performed with the use of SPSS 18 .0 software .RESULTS Totally 68 cases were cured in the ex‐perimental group ,with the cure rate of 97 .14% ,and 65 cases were cured in the control group ,with the cure rate of 92 .86% ;the complications occurred in 2 cases in the experimental group ,with the incidence rate of 2 .86% , and the complications occurred in 5 cases in the control group ,with the incidence rate of 7 .14% ,there was signifi‐cant difference between the two groups （P〈0 .05） .The result of one‐year follow‐up showed that both the Gan‐land score and Werley score （defect loss score） of the experimental group were better than those of the control group （P〈0 .05） .The adverse reactions occurred in 3 cases of the control group ,with the incidence rate of 4 .29% ,and the adverse reactions did not occurred in any patient of the experimental group .CONCLUSION The research reveals that the phase II revision surgery achieves more significant curative effect than dose the phase I re‐vision surgery .