人工髋关节置换术后手术部位感染的病原菌分布和危险因素分析

Pathogen distribution and risk factors of surgical site infection after artificial hip replacement

目的分析人工髋关节置换术后手术部位感染(surgical site infection,SSI)的病原菌分布情况及危险因素。方法回顾性分析荆门市第一人民医院创伤手足骨科2010年1月-2018年1月收治的髋关节置换术患者994例的年龄、性别、糖尿病、血清白蛋白、手术时间、术后抗菌药物使用时间、引流管放置时间等临床资料,分析人工髋关节置换术后SSI患者的病原菌分布情况,以及SSI发生的危险因素。结果994例患者发生手术部位感染31例,感染率3.12%,检出病原菌27株,主要为革兰阳性菌,占70.37%;Logistic多因素回归分析结果显示,患者年龄、合并糖尿病、血清白蛋白含量、手术时间、术中输血量、引流管放置时间、髋关节手术史、贫血、长期类固醇激素使用史、吸烟是人工髋关节置换术后患者发生SSI的独立危险因素(P<0.05)。结论人工髋关节置换术后发生SSI与多种因素相关,为降低感染发生率必须从多方面、多阶段综合预防。

OBJECTIVE To analyze the pathogen distribution and risk factors of surgical site infection after artificial hip replacement.METHODS Retrospective analysis of clinical data,including age,gender,diabetes mellitus,serum albumin,operation time,time of antimicrobial use after operation,time of drainage tube placement,of 994 hip replacement patients admitted from Jan.2010 to Jan.2015 in Jingmen First People’s Hospital was conducted.The distribution of pathogens in patients with surgical site infection after artificial hip replacement and the risk factors of surgical site infection after artificial hip replacement were analyzed.RESULTS There were 31 cases of surgical site infections in 994 patients,and the infection rate was 3.12%.Totally 27 strains of pathogens were detected,mainly Gram-positive bacteria,accounting for 70.37%.Logistics multivariate regression analysis showed that patient age,diabetes mellitus,serum albumin levels,operation time,intraoperative blood transfusion volume,drainage tube placement time,hip surgery history,anemia,long-term steroid use history,and smoking were independent risk factors for surgical site infection after artificial hip replacement(P<0.05).CONCLUSION Surgical site infection after artificial hip replacement is associated with multiple factors.To reduce the incidence of infection,comprehensive prevention must be carried out in many aspects and at multiple stages.