个性股骨假体置换术后患者感染病原菌分布及耐药性研究

发布时间：2018-05-14 03:26

本文选题：人工股骨假体 + 病原菌　；参考：《中华医院感染学杂志》2017年23期

【摘要】：目的探究采用医用CT技术结合计算机辅助设计重建个性股骨假体并进行置换术后感染病原菌的分布、耐药性、感染部位及危险因素。方法选取2011年7月-2016年6月于医院接受股骨假体置换术的患者202例,回顾患者的临床资料,个性化分析股骨假体置换术后感染的危险因素,经无菌操作,对感染患者标本进行病原菌培养、分离和鉴定,并经药敏试验了解其耐药性。结果股骨假体置换术的202例患者中有36例感染患者,感染率为17.82%;36例股骨假体置换术感染患者分离出病原菌46株,以革兰阳性菌为主,共31株占67.39%;主要革兰阳性菌对青霉素、头孢克洛、头孢呋辛、头孢唑林的耐药率较高,均≥50.00%,对万古霉素的耐药率较低;Logistic多元回归分析结果显示,年龄、手术时间、术中输血量、引流时间、是否长期使用抗菌药物、血红蛋白、血清白蛋白是股骨假体置换术后感染的独立危险因素(P0.05)。结论个性股骨假体置换术后患者的感染病原菌以革兰阳性菌为主,且耐药率较高。
[Abstract]:Objective to investigate the distribution, drug resistance, infection site and risk factors of the infection pathogens after the reconstruction of individual femoral prosthesis by medical CT and computer aided design. Methods 202 patients undergoing femoral prosthesis replacement were selected from July 2011 to June 2016. The clinical data of the patients were reviewed and the risk factors of infection after femoral prosthesis replacement were analyzed. The pathogens of infected patients were cultured, isolated and identified, and their drug resistance was determined by drug sensitivity test. Results among 202 cases of femoral prosthesis replacement, 36 cases were infected, and the infection rate was 17.82%. 46 strains of pathogenic bacteria were isolated from 36 cases of femoral prosthesis replacement, 31 strains were Gram-positive bacteria (67.39%), and the main gram-positive bacteria were penicillin. The drug resistance rate of cefaclor, cefuroxime and cefazolin was higher than that of cefazolin. The results of logistic multivariate regression analysis showed that age, operation time, intraoperative blood transfusion, drainage time and long-term use of antibiotics were lower than those of vancomycin resistance. Hemoglobin and serum albumin were the independent risk factors of infection after femoral prosthesis replacement. Conclusion Gram-positive bacteria are the main pathogenic bacteria in patients with personality femoral prosthesis replacement, and the drug resistance rate is higher.
【作者单位】：十堰市太和医院湖北医药学院附属医院骨科;湖北医药学院计算机教研室;湖北医药学院附属东风医院骨科;
【基金】：湖北省科技计划基金资助项目(2015CFC808)
【分类号】：R446.5;R687.3

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