人工髋关节置换术后患者感染病原菌分析

Distribution of pathogens causing postoperative infections in patients undergoing artificial hip replacement surgery

目的探讨人工髋关节置换术后手术部位早期感染的病原菌分布及相关危险因素,为降低人工髋关节置换术后感染提供参考依据。方法回顾性分析医院2010年4月-2015年3月1 010例行髋关节置换术患者的临床资料,分析术后手术部位早期感染病原菌分布特点,logistic回归分析感染相关危险因素,应用SPSS 15.0软件进行统计分析。结果 1 010例患者术后发生手术部位早期感染30例,感染率为2.97%,共检出病原菌19株,其中革兰阳性菌14株占73.68%,革兰阴性菌5株占26.32%;多因素logistic回归分析结果显示,高龄、手术持续时间长、引流时间长、低白蛋白水平、既往髋关节手术史、合并糖尿病是人工髋关节置换术后感染的独立危险因素(P<0.05)。结论人工髋关节置换术后手术部位早期感染病原菌以革兰阳性菌为主,手术部位感染影响因素较多,临床上应采取相应的预防措施。

OBJECTIVE To explore the distribution of pathogens causing postoperative surgical site infections in patients undergoing artificial hip replacement surgery and analyze the related risk factors so as to reduce the incidence of postoperative infections in the patients undergoing the artificial hip replacement surgery.METHODS The clinical data of 1 010 patients who underwent the hip replacement surgery from Apr 2010 to Mar 2015 were retrospectively analyzed,then the distribution of the pathogens causing the postoperative surgical site infections was observed,the logistic regression analysis was conducted for the related risk factors for the infections,and the statistical analysis was performed with the use of SPSS15.0software.RESULTS The postoperative surgical site infections occurred in 30 of 1 010 patients,with the infection rate 2.97%.A total of 19 strains of pathogens were isolated,including 14（73.68%）strains of gram-positive bacteria and 5（26.32%）strains of gram-negative bacteria.The multivariate logistic regression analysis indicated that the independent risk factors for the postoperative infections in the patients undergoing artificial hip replacement surgery included the advanced age,long operation duration,long drainage time,low level of albumin,history of hip surgery,and complication of diabetic mellitus（P0.05）.CONCLUSIONThe gram-positive bacteria are dominant among the pathogens causing the postoperative surgical site infections in the patients undergoing the artificial hip replacement surgery.There are a variety of influencing factors for the surgical site infections.It is necessary for the hospital to take corresponding prevention measures.