特制全膝关节置换术后感染的原因分析及防治

目的：探讨特制全膝关节置换术后感染的原因及预防措施。方法：对8例特制全膝关节置换术后感染的患者进行回顾性分析调查，针对术前、术中、术后不同时期的治疗流程中可能引起感染的原因进行分析。结果：8例特制全膝关节置换术后感染患者术前住院时间平均18d，手术时间平均5．4h，切口长度平均26cm，术后引流量平均445ml，术后引流时间平均4．5d，首次置换术前穿刺或切开活检次数平均2．6次，诊断感染前每个关节穿刺次数平均5．5次，假体均采用特制铰链式膝关节假体。结论：特制全膝关节置换术后患者除具有一般全膝关节置换术所存在的易感因素外，其切口大，手术时间长，软组织损伤重，假体占位体积大，术前穿刺或手术次数及诊断感染前穿刺次数多，术后引流时间长，是造成感染的高危因素。

The cause and prophylaxis of infected custom-made prosthetic knee replacement

Objective:To explore the cause and prophylaxis of infected custom-made prosthetic knee replacement. (Methods:8 )patients with infected custom-made prosthetic knee replacement were selected to retrospectively analyze the possible cause during pre-, intra-, and post-operation. Results:All 8 patients were subjected to custom-made hinged prosthetics. The mean hospitalization time before operation was 18 days; the mean operation duration, length of incision, and drainage volume were 5.4h, 26cm, 445ml, respectively. The mean number of puncture or arthrotomy before primary arthroplasty was 2.6, and the mean number of puncture before diagnosis of infection of each joint was 5.5. Conclusion: Besides the predisposing factors of common total knee arthroplasty, the custom-made prosthetic knee replacement had longer incision, longer operation duration, more traumatic soft tissue, larger prosthetic volume,more numbers of puncture or arthrotomy before operation and diagnosis,and longer duration of drainage after operation; which put the patients at high risk of infection.