全髋关节置换术后感染发生的相关因素分析及护理

Retrospective analysis of the incident rate and risk factors of postoperative infection of total hip arthroplasty and the related nursing strategies

目的探讨全髋关节置换术(total hip arthroplasty,THA)术后感染发生的相关因素并提出相关护理措施。方法回顾性分析新疆某三甲医院2013年10月-2016年10月2 000例THA患者资料,分析不同性别、年龄、BMI、手术方式、伴随疾病及手术时间特征下THA术后感染发生率的差异,采用二分类Logistic回归分析方法对THA术后感染的相关危险因素进行分析,并提出相应的护理措施。结果 2 000例接受THA的患者中,共有63例患者发生感染,发生率为3.2%。不同性别患者THA术后感染发生率差异有统计学意义,男性的发生率高于女性;不同年龄、BMI、手术方式、伴随疾病患者THA术后感染发生率差异均有统计学意义(P<0.001),并且双侧THA患者术后感染发生率高于单侧THA患者。伴随疾病(OR值1.68)、双侧手术(OR值1.55)、BMI≥18.5(OR值1.37)、年龄>50岁(OR值1.27)及性别(OR值1.08)等因素是THA后感染发生率增高的相关危险因素。结论对具有感染高危因素的THA患者实施相应护理措施,能够降低感染的发生率。

Objective To discuss the risk factors affecting postoperative infection after total hip arthroplasty(THA)and propose the related nursing strategies.Methods A retrospective analysis of 2000 cases of THA between October 2013 and October 2016 from a hospital in Xinjiang was conducted.The difference between the incidence of infectious diseases and operation time characteristics after THA and their gender,age,BMI and surgery pattern was analyzed using two Logistic classification method to find out the related risk factors of infection after THA and put forward the corresponding nursing measures.Results Among the 2000 patients who underwent THA,there were 63 cases of infection patients(infection rate of 3.2%)with significant difference;the incidence rate of infection of male was higher than female,and the difference between the incidence rate of infection and ages,BMIs,THA surgery pattern,and accompanied diseases were all statistically significant(P <0.001).and the incidence rate of infection of the bilateral THA patients is higher than that of the unilateral THA patients.The disease(OR =1.68),bilateral surgery(OR =1.55),BMI≥18.5(OR =1.37),>50 years(OR =1.27)and gender(OR =1.08)and others may be the potential risk factors for increased infectious rate after THA.Conclusion Implementing corresponding nursing strategies for patients targeting on the high risk factors could reduce the incidence rate of infection after THA.