全膝关节置换后感染的随访分析

背景：人工关节置换后感染是人工关节置换最严重的并发症之一，但有关感染发生相关危险因素的研究报道较少。 目的：分析影响全膝关节置换后感染的危险因素。 方法：对122例全膝关节置换后感染发生情况进行分析。其中男25例，女97例，平均年龄63.1岁(27~82岁)，平均随访3.6年。采用Logistic多因素回归分析方法对性别、年龄、肥胖程度、关节原发病(是否为免疫相关性疾病)、糖尿病/高血压、肿瘤、关节内注射类固醇类消炎药史、假体类型、术中失血量、手术持续时间、术后伤口引流量、术后发热(> 38 ℃)持续时间、术后1 d血色素13项临床因素与全膝关节置换后感染的相关性进行分析。 结果与结论：置换后发生感染9例，发生率为7.4%。Logistic多因素回归分析表明，与感染相关的因素中手术持续时间长、术后伤口引流量多及术后发热持续状态长者，置换后发生感染的风险分别增加到5.823，10.561，7.757倍(P < 0.05)。提示手术持续时间、术后伤口引流量及术后发热持续状态是预测全膝关节置换后感染发生的危险因素。

Analysis of risk factors for infection after total knee arthroplasty

BACKGROUND: Infection is one of the most serious complications after total knee arthroplasty (TKA). But few studies focus on the risk factors related to infection. OBJECTIVE: To analyze the clinical risk factors for infection after TKA. METHODS: Among 122 patients who underwent TKA, 25 were male and 97 were female, with an average age of 63.1 years (range, 27 to 82 years). All the cases were followed up for 3.6 years averagely. Clinical factors were examined to analyze their influences on infection after surgery, including sex, age, obesity degree, joint primary disease (immunity-related disease), diabetes mellitus/hypertension, tumor, history of steroid drugs into article, type of prosthesis, bleeding during operation, operative time, postoperative drainage, duration of fever (> 38 °C), and haematin at 1 day postoperation. RESULTS AND CONCLUSION: There were 9 patients who developed infection after TKA. The incidence of infection in all patients was 7.4%. Logistic regression analysis demonstrated a definite association of surgical duration, volume of drainage and duration of fever after operation. The three factors increased the risk of infection with 5.823, 10.561, 7.757 times respectively (P < 0.05). Surgical duration, volume of drainage and duration of fever after operation are risk factors for infection after TKA.