髋膝关节置换术后感染的影响因素分析

Analysis on the influencing factors of infection after hip and knee arthroplasty

【目的】探讨髋膝关节置换术后感染的影响因素,为控制感染提供理论依据。【方法】回顾性分析2013年3月至2015年3月收治的237例髋膝关节置换术患者的临床资料,根据诊断标准分为术后感染组与未感染组,收集两组患者的性别、年龄、是否肥胖、手术时间、是否放置引流管、引流管放置时间、引流量、有无脓性渗液、有无糖尿病、有无类风湿性关节炎、是否使用激素及手术史等,进行Logistic单因素分析与多因素分析。【结果】患者术后感染率为11.39%(27/237),感染部位以手术部位为主,占51.85%(14/27)。手术时间>2 h、引流管放置时间>2 d、引流量>200 ml、脓性渗液、糖尿病、使用激素患者的感染风险分别增加3.100倍、2.726倍、2.334倍、72.3%、28.6%、1.982倍(P<0.05),放置引流管使术后感染风险减少7.5%(P<0.05)。【结论】手术时间长、长期放置引流管、引流量大、脓性渗液、糖尿病及使用激素是术后感染的危险因素,而放置引流管为保护因素。

[ Objective ] To explore the influencing factors of infection after hip and knee arthroplasty, and provide theoretical basis for infection control. [Methods] The clinical data of 237 patients undergoing hip and knee arthroplasty from March 2013 to March 2015 were retrospectively analyzed. According to the diagnostic criteria, the patients were divided into postoperative infection group and non- infection group. Univariate and multivariate Logistic analysis was used to analyze the clinical data including gender, age, obesity, operation time, placement of drainage tube, drainage time, drainage volume, purulent exudate, diabetes, rheumatoid arthritis, use of hormones and operation history. [Results] The rate of postoperative infection was 11.39% （27/237）. The main infection site was surgical site, accounting for 51.85% （14/27）. The infection risks of operation time 〉 2 h, drainage time 〉 2 d, drainage volume 〉 200 ml. purulent exudate, diabetes and use of hormone increased 3.100 times, 2.726 times, 2.334 times, 72.3%, 28.6% and 1.982 times respectively （P〈 0.05）. The infection risk of drainage-tube placement decreased 7.5% （P〈 0.05）. [Gonclusion] The risk factors of postoperative infection are as follows： long operation time, long-term placement of drainage tube, large drainage volume, purulent exudate, diabetes and use of hormones, while drainage-tube placement is a protective factor.