影响初次全膝关节置换术手术时间及深层感染翻修风险因素分析

Analysis of the risk factors influencing the operation time of primary total knee arthroplasty and revision of deep infection

目的:探讨影响初次全膝关节置换术(TKA)手术时间及深层感染翻修的风险因素。方法:选择初次行TKA治疗的病人作为研究对象,通过单因素进行χ2检验与Pearson相关检验及多因素logistic回归分析探讨影响初次TKA手术时间及深层感染翻修的风险因素及独立危险因素。结果:多因素分析结果显示,男性、美国麻醉医师协会(ASA)分级Ⅲ~Ⅳ级、体质量指数>28 kg/m^(2)是影响手术时间的独立因素(P<0.01),年龄≥75岁、糖尿病、术后白蛋白<30 g/L、手术时间≥110 min、性别是术后深部感染翻修的独立影响因素(P<0.05~P<0.01)。年龄、糖尿病、术后白蛋白、性别与深部感染翻修的相关性系数分别为0.287、0.265、-0.297和0.302(P<0.05)。结论:男性、ASA分级Ⅲ~Ⅳ级、体质量指数>28 kg/m^(2)是影响初次TKA手术时间的独立因素;年龄≥75岁、糖尿病、术后白蛋白<30 g/L、手术时间≥110 min、性别是术后深部感染翻修的独立影响因素。初次TKA手术时间和深层感染翻修是多种因素综合影响的结果,临床工作中应充分识别这些影响因素并制订针对性干预方案,以改善预后。

Objective:To explore the risk factors affecting the operation time of primary total knee arthroplasty(TKA)and revision of deep infection.Methods:The patients treated with TKA for the first time were included in the study.The risk factors and independent risk factors influencing the operation time of primary TKA and revision of deep infection were analyzed using theχ2 test,Pearson correlation test and multivariate logistic regression.Results:The results of multivariate analysis showed that the male,ASA gradeⅢ~Ⅳand body mass index>28 kg/m 2 were the independent factors affecting the operation time(P<0.01),and the age≥75 years,diabetes mellitus,albumin<30 g/L,operation time≥110 min and gender were the independent factors influencing the revision of deep infection after operation(P<0.05 to P<0.01).The correlation coefficients of age,diabetes mellitus,postoperative albumin and gender with deep infection revision were 0.287,0.265,-0.297 and 0.302,respectively(P<0.05).Conclusions:The male,ASA gradeⅢ-Ⅳ,body mass index>28 kg/m 2 are the independent factors influencing the operation time of primary TKA,and the age≥75 years,diabetes mellitus,postoperative albumin<30 g/L,operation time≥110 min and gender are the independent factors influencing the revision of deep infection.The operation time of primary TKA and revision of deep infection are the results of multiple factors,which should be fully identified in clinical work,and the targeted interventions should be formulated to improve the prognosis.