髋膝关节置换术后手术部位感染的危险因素分析及预防对策

目的 探讨髋、膝关节置换术后手术部位感染的危险因素,分析预防对策.方法 回顾性分析2007年3月至2011年12月行髋、膝关节置换术患者的186份病历资料,包括患者姓名、性别、年龄、病史等一般资料以及手术类型、住院时间、是否发生感染等可能与手术部位感染相关的因素;采用x2检验进行危险因素分析.结果 术前合并恶性肿瘤、其他慢性感染或类风湿性关节炎的患者术后手术部位感染率高,分别为33.3％、28.5％和20.0％;患者年龄、备皮时间、异体输血、术后引流及住院时间是影响髋膝关节置换术后手术部位感染的危险因素(P＜0.05).结论 术前合并恶性肿瘤、其他慢性感染或类风湿性关节炎的患者术后更易发生手术部位感染;临床应采取积极的预防措施、加强护理的配合以避免或减少感染的发生.

Risk factors and prevention countermeasures for surgical site infections after hip and knee arthroplasty

OBJECTIVE To investigate the risks factors and prevention countermeasures for the surgical site infections after the hip and knee arthroplasty.METHODS The clinical data of 186 patients who underwent the hip and knee arthroplasty in the hospital from Mar 2007 to Dec 2011 were retrospectively analyzed.The clinical data including the name,gender,age,and medical history as well as the risk factors for the surgery type,hospitalization duration,and the nosocomial infections were analyzed.The χ2 test was applied for the analysis of the risk factors.RESULTS The incidence rates of surgical site infections in the patients with a history of malignant tumor,the patients with chronic infections,and the patients with rheumatoid arthritis were 33.3%,28.5%,and 20.0%.The age,the duration of skin-preparation,allogeneic transfusion,postoperative drainage,and hospitalization duration were the risk factors for the surgical site infections after the hip and knee arthroplasty(P<0.05).CONCLUSION The patients with a history of malignant tumor,chronic infections and the rheumatoid arthritis were more prone to the surgical site infections.The hospital should take active prevention measures and strengthen the nursing so as to avoid or prevent the incidence of nosocomial infections.