高龄髋膝关节置换术后致假体周围感染的相关因素分析

目的：分析高龄髋膝关节置换术后致假体周围感染发生的相关因素，以期为高龄患者术后感染的控制提供依据。方法选取2013年1月至2015年10月我院重症医学科收治的31例高龄髋膝关节置换术后假体周围感染患者为观察组，同期的31例未发生感染患者为对照组，比较两组患者的年龄、BMI值、手术时间、血清白蛋白水平、基础疾病并发率、其他感染病灶存在率、引流管留置时间及髋膝部位创伤史率，同时以Logistic回归分析上述指标与感染的关系。结果观察组患者的年龄、BMI值、手术时间、基础疾病并发率、其他感染病灶存在率、引流管留置时间及髋膝部位创伤史率分别为(78.42±5.21)岁、(25.16±2.32) kg/m2、(2.56±0.30) h、58.06%、35.48%、(31.64±2.76) h及32.26%，均高于对照组的(72.60±4.81)岁、(22.87±2.14) kg/m2、(1.98±0.22) h、32.26%、12.90%、(24.08±2.53) h及12.90%，血清白蛋白水平为(31.82±3.85) g/L，低于对照组的（37.67±4.25）g/L，差异均有统计学意义(P<0.05)，且经Logistic回归分析结果显示，上述指标均为术后假体周围感染发生的危险因素(P<0.05)。结论年龄、BMI值、手术时间、血清白蛋白水平、基础疾病并发率、其他感染病灶存在率、引流管留置时间及髋膝部位创伤史率均是高龄髋膝关节置换术后假体周围感染发生的相关因素，临床上应给予充分的重视，及时采用干预措施。

Related factors of infection around the prosthesis of patients with advanced age after hip and knee arthroplasty

Objective To analyze the related factors of infection around the prosthesis of patients with ad-vanced age after hip and knee arthroplasty, in order to provide evidence for the control of postoperative infection of pa-tients with advanced age. Methods A total of 31 patients of advanced age with infection around the prosthesis after hip and knee arthroplasty, who admitted to Intensive Care Unit (ICU) of our hospital from January 2013 to October 2015, were selected as the observation group. At the same time, 31 patients without infection were selected as the control group. Then the ages, body mass index (BMI) value, operation time, serum albumin level, basic disease rates, other infec-tion sites rates, drainage tube indwelling time, trauma history rates of hip and knee of the two groups were compared, and the relationship between those indexes and infection were analyzed by the logistic regression analysis. Results The age, BMI value, operation time, basic disease rates, other infection sites rates, drainage tube indwelling time, trauma his-tory rates of hip and knee of the observation group were respectively (78.42 ± 5.21) years, (25.16 ± 2.32) kg/m2, (2.56 ± 0.30) h, 58.06%, 35.48%, (31.64±2.76) h and 32.26%, which were all higher than (72.60±4.81) years, (22.87±2.14) kg/m2, (1.98±0.22) h, 32.26%, 12.90%, (24.08±2.53) h and 12.90%of the control group;while the serum albumin level (31.82± 3.85) g/L of the observation group was lower than (37.67 ± 4.25) g/L of the control group;all of the above differences were statistically significant (P<0.05). Logistic regression analysis showed that those indexes all had close relationship with the postoperative infection around the prosthesis (P<0.05). Conclusion The age, BMI value, operation time, se-rum albumin level, basic disease rates, other infection sites rates, drainage tube indwelling time, trauma history rates of hip and knee are all the related factors of infection around the prosthesis of patients with advanced age after hip and knee arthroplasty, so the indexes should be paid enough attention, and timely intervention measures should be taken.