人工髋关节置换术后早期感染的预防策略分析

Analysis of the prevention strategy of early infection after artificial hip replacement

目的探讨人工髋关节置换术后预防性使用抗生素24 h与72 h对术后早期感染发生的影响。方法选取2012年1月至2013年3月间于我院行人工髋关节置换手术的患者320例,随机分为A组和B组,其中A组术前1小时使用抗生素至术后24小时后停用,B组术前1小时使用抗生素至术后72小时后停用。术后随访6个月,观察并对比分析A组、B组患者术后3个月内感染的发生情况。结果 A组患者的感染发生率为5.63%,B组为5.00%,组间比较差异无统计学意义(P>0.05);对于相同诊断类型及相同手术方式患者而言,两组的感染发生率间差异无统计学意义(P>0.05);所有术后感染患者,均行抗菌药物或再次手术清创治疗得以痊愈,无严重并发症发生。结论围手术期预防性使用抗菌药物可降低人工髋关节置换术后早期感染的发生,一般地,抗生素应于术后24 h停用,即可减少耐药菌株的产生,同时,可减轻患者的经济负担。

Objective To explore the effect of using antibiotic prophylaxis for 24 h and 72 h on the occurrence of early postoperative infection in hip arthroplasty. Methods From January 2012 to March 2013,320 patients who received artificial hip joint replacement operation in our hospital were enrolled in this study. They were randomly divided into A group and B group. Patients in the A group received preoperative antibiotics treatment one hour before operation and canceled 24 hours after operation,in group B the treatment lasted for 72 hours. Patients were followed up for 6 months,observed and compared the occurrence of infection of the two groups within 3 months. Results The infection rate in the A group was 5. 63% and it was 5% in B group,there was no significant difference between the two groups（ P〉0. 05）. For the patients with the same diagnosis type and the same operation mode,the infection rate between two groups had no statistical difference（ P〉0. 05）.Infections in patients after operation were cured by the using of antimicrobial agents or debridement,no serious complications occurred. Conclusions Prophylactic use of antibiotics may reduce the occurrence of early infection after artificial hip replacement operation. Generally,antibiotics should be stopped in the postoperative 24 hours,so it can reduce the production of drug- resistant,meanwhile,can relieve patients＇ economic burden.