全髋关节置换术后切口感染的危险因素与病原学分析

发布时间：2018-02-24 23:08

本文关键词： 全髋关节置换切口感染危险因素病原学耐药性　出处：《中华医院感染学杂志》2017年12期 　论文类型：期刊论文

【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(P0.05);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VA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。
[Abstract]:Objective to investigate the risk factors and etiological characteristics of incision infection after total hip replacement. Methods 811 patients underwent total hip replacement from June 2009 to October 2016 were analyzed retrospectively and their clinical features were analyzed. Results there were 20 cases of incision infection in 811 patients. The infection rate was 2.47 logistic regression analysis showed that the preoperative levels of hemoglobin and albumin were low and the operation time was too long. The risk factors of incision infection after total hip arthroplasty were large amount of intraoperative bleeding, large amount of blood transfusion during perioperative period, long drainage time after operation and long days of ICU, which were the risk factors of incision infection after total hip arthroplasty (THR). Staphylococcus aureus was the most common gram-positive bacteria, and the resistance rates to moxifloxacin and penicillin G were 88.89% and 94.44, respectively, while gram-negative bacteria were Escherichia coli. The rates of resistance to ceftitan and sulfamethazol / trimethoprim were 86.87% and 93.33 respectively. Conclusion the overall incidence of incision infection after total hip arthroplasty is lower, but there are many risk factors and no obvious specificity of pathogenic bacteria.
【作者单位】：绍兴文理学院附属医院骨一科;上海市第六人民医院骨科;
【基金】：浙江省医药卫生一般研究计划基金资助项目(2015KYA224)
【分类号】：R687.4

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