文献类型：期刊文献

中文题名：全髋关节置换术后切口感染的危险因素与病原学分析

英文题名：Risk factors for postoperative incision infections in patients undergoing total hip arthroplasty and etiological analysis

作者：刘明东[1];周祖彬[2];刘国太[1];孟延丰[1];佟杰[1];赵伟英[1]

机构：[1]绍兴文理学院附属医院骨一科;[2]上海市第六人民医院骨科

年份：2017

卷号：27

期号：12

起止页码：2767

中文期刊名：中华医院感染学杂志

外文期刊名：Chinese Journal of Nosocomiology

收录：CSTPCD、、北大核心2014、CSCD_E2017_2018、北大核心、CSCD

基金：浙江省医药卫生一般研究计划基金资助项目(2015KYA224)

语种：中文

中文关键词：全髋关节置换;切口感染;危险因素;病原学;耐药性

外文关键词：Total hip arthroplasty;Incision infection;Risk factor;Etiology;Drug resistance

中文摘要：目的探讨全髋关节置换术后切口感染的危险因素及相关病原学特点。方法回顾性分析自2009年6月-2016年10月医院接受全髋关节置换手术患者811例,分析患者临床特征,术后感染危险因素,病原学及耐药性等资料。结果 811例患者中共20例出现切口感染,感染率为2.47%;Logistic回归分析显示糖尿病,术前血红蛋白及白蛋白水平低、手术时间过长、术中出血量大、围手术期输血量大、术后引流时间过长及ICU天数过长是全髋关节置换术后切口感染的危险因素(P<0.05);在病原学及药敏结果方面,革兰阳性菌以金黄色葡萄球菌最为常见,对莫西沙星和青霉素G耐药率分别达88.89%和94.44%;革兰阴性菌以大肠埃希菌最为常见,对头孢替坦和磺胺甲噁唑/甲氧苄啶耐药率分别达86.87%和93.33%。结论全髋关节置换术后切口感染整体发病率较低,但危险因素较多,病原菌无明显特异性,临床需加强防护措施。

外文摘要：OBJECTIVE To explore the risk factors for postoperative incision infections in patients undergoing total hip arthroplasty and observe the related etiological characteristics.METHODS A total of 811 patients who received the total hip arthroplasty in hospitals from Jun 2009 to Oct 2016 were retrospectively analyzed,the clinical characteristics and risk factors for the postoperative infections were analyzed,and the etiological characteristics and drug resistance were observed.RESULTS Of the 811 patients,20 had incision infections,with the infection rate 2.47%.The logistic regression analysis indicated that the risk factors for the postoperative incision infections in the patients undergoing the total hip arthroplasty included diabetic mellitus,low levels of preoperative hemoglobin and albumin,long operation duration,large volume of intraoperative blood loss,large amount of perioperative blood transfusion,prolonged postoperative drainage time,and excessively long ICU stay （P〈0.05）.The results of etiological analysis and drug susceptibility testing showed that the Staphylococcus aureus was the most common species of gram-positive bacteria,the drug resistance rates to moxifloxacin and penicillin G were 88.89% and 94.44%,respectively;the Escherichia coli was the predominant species of gram-negative bacteria,and the drug resistance rates to cefotetan and sulfamethoxazole-trimethoprim were 86.87% and 93.33%,respectively.CONCLUSION The incidence rate of postoperative incision infection is relatively low in the patients undergoing the total hip arthroplasty,there are a variety of risk factors,the pathogens do not show significant specificity,and it is necessary for the hospital to strengthen the prevention.