万古霉素粉剂在全髋关节置换术后预防假体周围感染的应用效果

Efficacy of vancomycin powder in the prevention of periprosthetic infection after total hip arthroplasty

目的探讨万古霉素粉剂在全髋关节置换术后假体周围感染预防中的应用效果及对术后感染的影响。方法选取2018年10月至2020年5月蚌埠医学院第一附属医院收治的全髋关节置换术患者100例,按随机数字表法将其分为2组,对照组进行常规术后假体周围感染预防,研究组在对照组的条件上进行万古霉素粉剂假体周围感染预防。比较2组患者预防效果、术后感染发生率、感染的临床特征、髋关节功能。结果研究组预防效果优于对照组(P<0.05),术后感染发生率低于对照组(P<0.05);对照组共发生感染5例,感染的类型分别为表皮感染2例(4.0%),深部组织感染3例(6.0%),病原菌主要有金黄色葡萄球菌、大肠埃希菌;研究组共发生感染2例,其中表皮感染1例(2.0%),深部组织感染1例(2.0%),病原菌主要有金黄色葡萄球菌、肺炎克雷伯菌;研究组髋关节功能优于对照组(P<0.05)。结论万古霉素粉剂在全髋关节置换术后假体周围感染预防中预防效果显著。

Objective To investigate the efficacy of vancomycin powder in the prevention of periprosthetic infection after total hip arthroplasty and its effect on the incidence of postoperative infection.Methods A total of 100 patients with total hip arthroplasty admitted to the hospital from October 2018 to May 2020 were enrolled as study subjects and were randomly divided into 2 groups.The control group was treated with routine postoperative periprosthetic infection prevention,while the study group received periprosthetic in⁃fection prevention with vancomycin powder on the basis of the control group.Preventive effect,infection rate after surgery,clinical char⁃acteristics of infection and hip joint function were compared between the patients of the 2 groups.Results The prevention effect of the study group was superior to that of the control group(P<0.05),and the rate of postoperative infection in the study group was lower than that in the control group(P<0.05).Of the 5 cases in the control group,2 were epidermal infection(4.0%)and 3 were deep tissue infection(6.0%).The main pathogens involved were Staphylococcus aureus and Escherichia coli.In the study group,there were 2 cases of infection,of which one was epidermal infection(2.0%)and the other was deep tissue infection(2.0%).The main pathogens were Staphylococcus aureus and Klebsiella pneumoniae.Hip joint function of the study group was better than that of the con⁃trol group(P<0.05).Conclusion Vancomycin powder is effective in preventing periprosthesis infection after total hip arthroplasty and is worth further clinical application.