120例人工膝关节置换术后感染诊断回顾性分析

目的探讨膝关节表面置换术后感染的相关影响因素和诊断方法的差异性,为早期预防该类感染提供临床依据。方法对本组自2001年2月至2011年7月收治的120例膝关节表面置换术后感染的患者进行回顾性分析,其中男47例,女73例,平均年龄69岁,采用Logistic多因素回归分析方法对患者发病的相关因素和医生诊断该病的方法进行分析。结果 Logistic回归分析表明,类风湿关节炎（P〈0.05）、糖尿病（P〈0.05）、肿瘤（P〈0.01）、激素服用史（P〈0.01）、高血尿酸症（P〈0.05）和伴发其它系统感染（P〈0.05）是关节表面置换术后感染的高危险因素,WBC（P〈0.01）、ESR（P〈0.01）、CRP（P〈0.01）、关节液常规生化（P〈0.01）、关节液细菌培养（P〈0.05）、组织微生物培养（P〈0.01）指标对膝关节表面置换术后感染的早期诊断较其他方法更加方便。结论早期详细询问病史,积极治疗合并症对预防术后感染有重要的作用,同时,在对感染做诊断时,联合多种指标检测,能够提高膝关节表面置换术后感染的诊断率。

Retrospective anlalysis of postoperative infection diagnosis for 120 cases of knee arthroplasty

Objective To discuss the relevant factors of postoperative infection and the differences of diagnosis methods in total knee arthroplasty （TKA）, so as to provide clinical evidence for early prevention of the infection. Methods Between February, 2001 and July, 2011, 120 infected cases after TKA were analyzed, in which 47 were males and 73 were females, with an average age of 69 years old. Correlated factors of patients and diagnostic methods were analyzed to determine their influences on post-operative infection. Results Logistic regression analysis demonstrated that rheumatoid arthritis （P〈0.05）, glycuresis （P〈0.05）, tumour （P〈0.01）, steroids（P〈0.01）, high blood uric acid disease （P〈0.05）, and other systemic infections（P〈0.05）, were high risk factors of post-operative infection. WBC （P〈0.01）, ESR （P〈0.01）, CRP （P〈0.01）, biochemistry of joint fluid （P〈0.01）, bacterial culture of joint fluid （P〈0.05）, microorganisms culture of tissue （P〈0.01） were more convenient than other methods in the early diagnosis for the infection after knee joint arthroplasty. Conclusions To prevent post-operative infection of TKA, early inquiry of the history and treatment for complications are of great importance; combination of various diagnostic indicators can improve the diagnostic accuracy of the infection after TKA.