文章摘要
梁嘉铭.影响膝关节表面置换术后感染的相关因素分析.骨科,2015,6(1): 25-27.
影响膝关节表面置换术后感染的相关因素分析
Analysis of related factors influencing infection after knee arthroplasty
投稿时间:2014-10-14  
DOI:10.3969/j.issn.1674-8573.2015.01.007
中文关键词: 关节成形术,置换,膝  感染  危险因素  预防
英文关键词: Arthroplasty, replacement, knee  Infection  Risk factor  Prevention
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作者单位E-mail
梁嘉铭 511400 广州广州市番禺区中医院骨一区 gzhouljm82@126.com 
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中文摘要:
      目的 探究影响膝关节表面置换术后感染的相关因素。方法 回顾性分析2011年1月至2014年7月于我院行膝关节表面置换术的患者320例,根据患者膝关节表面置换术后是否感染分为感染组(n=13)和非感染组(n=307),运用统计学方法比较两组患者的一般资料、并发症、手术情况等。结果 通过单因素分析,发现美国麻醉师协会(America Society of Anesthesiologists,ASA)分级高、合并糖尿病、合并类风湿性关节炎、手术时间长、手术出血量多、有激素治疗史对术后感染的影响有统计学意义(P<0.05);通过多因素分析,发现合并糖尿病[比值比(OR)=4.384,95%可信区间(CI):1.668~9.522]、合并类风湿性关节炎(OR=6.203,95% CI:2.256~13.054)、手术时间(OR=2.396,95% CI:1.336~4.298)、手术出血量(OR=1.756,95% CI:1.177~2.619)、有激素治疗史(OR=4.536,95% CI:2.399~8.576)是膝关节表面置换术患者术后感染的危险因素。结论术前掌握患者的合并症和既往病史、激素治疗史,术中选择合适的手术方式,减少手术时间和出血量,术后加强监测患者病情,有利于降低患者术后的感染率。
英文摘要:
      Objective To explore the related factors influencing infection after knee arthroplasty. Methods 320 patients undergoing knee arthroplasty from Jan. 2011 to Jul. 2014 in our hospital were selected, and divided into infection group (n=13) and non-infection group (n=307) after knee arthroplasty. Age, gender, smoking history, history of alcoholism, ASA classification, combined diabetes mellitus, combined hypertension, rheumatoid arthritis, operation time, operation bleeding, history of hormone treatment in the two groups were compared. Results Single factor analysis showed that patients with higher ASA classification, combined diabetes mellitus, rheumatoid arthritis, longer operation time, more operation bleeding, history of hormone treatment had higher infection rate after knee arthroplasty (P<0.05). Multivariate analysis showed that combined diabetes mellitus (OR=4.384, 95% CI=1.668-9.522), rheumatoid arthritis (OR=6.203, 95% CI=2.256-13.054), operation time (OR=2.396, 95% CI=1.336-4.298), operation bleeding (OR=1.756, 95% CI=1.177-2.619), and history of hormone treatment (OR=4.536, 95% CI=2.399-8.576) were risk factors for infection after knee arthroplasty. Conclusion Understanding complication, history of past illness, and history of hormone treatment before operation, selecting appropriate surgical procedures, shortening the operation time and reducing bleeding volume during operation, and strengthening the monitoring of patient's conditions after operation can reduce postoperative infection rate.
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