人工髋关节置换术患者假体周围感染相关因素分析与干预对策研究

Analysis of factors related to periprosthetic infection in patients undergoing artificial hip joint replacement and its intervention strategies

目的探讨人工髋关节置换术患者假体周围感染相关因素与干预对策。方法选取2016年2月至2017年6月我院收治的人工髋关节置换术患者611例,对所有入选患者的详细资料进行回顾性的整理分析,使用COX回归模型来分析影响人工髋关节置换术患者假体周围发生感染的独立危险因素。结果 611例患者中有36例出现假体周围感染,占5.89%;分析结果提示,患者年龄≥65岁、合并糖尿病、手术时长≥2h、术后引流时长≥48 h及患者术后出现并发症是影响人工髋关节置换术患者发生假体周围感染的独立危险因素,差异存在统计学意义(P<0.05)。结论人工髋关节置换术患者发生假体周围感染与患者年龄≥65岁、合并糖尿病、手术时长≥2 h、术后引流时长≥48 h及患者术后出现并发症有较直接的关系。因此,给予人工髋关节置换术患者进行干预的过程中应该充分结合患者的实际情况,最大程度的降低患者的手术时长及相关药物治疗时间,特别是对自身合并严重慢性疾病(如糖尿病)的患者,应该积极采用全方面的措施干预来降低患者假体周围感染发生率。

Objective To explore the factors related to periprosthetic infection in patients undergoing artificial hip joint replacement and its intervention strategies. Methods To select 611 cases of patients with artificial hip arthroplasty admitted to our hospital from February 2016 to June 2017,and the detailed data of all selected patients were retrospectively analyzed. COX regression model was used to analyze the independent risk factor for infection around the prosthesis in patients with artificial hip arthroplasty. Results There were 36 cases among the 611 patients had periprosthetic infection,accounting for5. 89%. The results showed that the age of patient ≥65 years old,complicated with diabetes,the duration of surgery ≥2 hours,the length of postoperative drainage ≥48 hours,and complications after the operation were independent risk factors affecting the infection of the prosthesis in patients undergoing hip replacement surgery. The difference is statistically significant（ P〈0. 05）. Conclusion Periprosthetic infection in patients undergoing hip arthroplasty is directly related to factors such as the age of patients ≥65 years old,diabetes,operation time ≥2 hours,the length of postoperative drainage ≥48 hours,and postoperative complications. Therefore,during the intervention of patients undergoing artificial hip arthroplasty,it should fully integrate the actual situation of the patient to minimize the length of surgery and related drug treatment time,especially for patients with serious chronic diseases（ such as diabetes）.All aspects of intervention should be actively used to reduce the incidence of infection around the patient＇s prosthesis.