中国大陆居民髋膝关节置换后假体周围感染危险因素的Meta分析

Risk factors for periprosthetic joint infection after hip or knee arthroplasty in Mainland of China: a meta-analysis

背景:假体周围感染是关节置换术后严重的、灾难性的并发症。随着国内人口老龄化日趋明显,将有更多的患者面临关节置换手术,研究显示不同种族间关节置换术后感染的危险性存在差异。目的:通过Meta分析了解中国大陆居民髋膝关节置换术后假体周围感染的危险因素,为关节置换术后假体周围感染的预防与控制提供依据。方法:计算机检索中文数据库(万方、CNKI、维普、CBM)、外文数据库(Pub Med、Cochrane、Embase、Medline),并以手工检索、文献追溯等方法收集自建库至2016年9月公开发表的关于中国大陆居民髋膝关节置换术后假体周围感染危险因素的文献,按纳入、排除标准进行文献筛选,提取数据,采用stata 12.0软件进行分析。结果与结论:(1)共纳入14篇文献,假体周围感染417例关节;(2)Meta分析显示,合并糖尿病、有激素使用史、手术持续时间大于90 min、年龄大于65岁、既往膝髋关节手术史是髋膝关节置换术后假体周围感染的危险因素;(3)提示髋膝关节置换术后假体周围感染与多个因素相关,临床医师应注意相关危险因素,积极采取有效措施避免患者发生关节置换术后假体周围感染。

BACKGROUND： Periprosthetic joint infection （PJI） is a serious and catastrophic complication after hip or knee arthroplasty. With aging population increasing, more patients will undergo hip or knee arthroplasty. Studies have shown that the risk for PJI following arthroplasty is different in different populations. OBJECTIVE： To evaluate the risk factors for PJI after hip or knee arthroplasty in Mainland of China through a meta-analysis, thereby providing reference for the prevention and control of postoperative PJI. METHODS： A computer-based search of WanFang, CNKI, VIP, CBM, PubMed, Cochrane, Embase and Medline databases was performed and the literatures concerning the risk factors for PJI after hip or knee arthroplasty in Mainland of China published before September 2016 were collected by manual retrieval and retrospective approach. All the literatures were screened based on the inclusion and exclusion criteria, followed by data extraction and analyzed on RESULTS AND CONLUSION： （1） Finally 14 literatures were included, including 417 patients with PJI. （2） The results of the meta-analysis showed that the risk factors for PJI after hip or knee arthroplasty including the complication of diabetic mellitus, long-term use of steroids, long operation time （〉 90 minutes）, age （〉 65 years）, and history of hip or knee Stata 12.0 software. surgery. （3） To conclude, PJI after hip or knee arthroplasty is related to multiple factors, so physicians should pay attention to these factors to reduce the incidence of PJI.