CAJ | 학술논문

目的：探讨人工髋关节置换术后感染的危险因素，提出有效的预防对策，为早期预防和控制人工髋关节置换术后感染提供依据。方法回顾性分析2004年1月－2012年12月在医院行人工髋关节置换术的992例患者临床资料，将发生感染的15例患者作为研究组，未发生感染的977例患者作为对照组，对比两组患者的临床资料，分析人工髋关节置换术后感染的危险因素及预防对策。结果992例患者人工髋关节置换术后共发生感染15例，感染率为1．51％；检出病原菌15株，排前5位病原菌依次为金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌、表皮葡萄球菌、肺炎克雷伯菌，分别占33．33％、20．00％、20．00％、13．33％、6．67％；患者年龄、有基础疾病、合并糖尿病、有激素长期应用史、术前血清白蛋白及血红蛋白含量低、手术时间及引流时间是人工髋关节置换术后感染的危险因素（P＜0．05）。结论人工髋关节置换术后感染的原因较多，与患者高龄、激素的长期应用、合并多种内科基础疾病等因素有关，根据高危因素有针对性的采取相应的预防对策，可降低感染发生率。
목적：탐토인공관관절치환술후감염적위험인소，제출유효적예방대책，위조기예방화공제인공관관절치환술후감염제공의거。방법회고성분석2004년1월－2012년12월재의원행인공관관절치환술적992례환자림상자료，장발생감염적15례환자작위연구조，미발생감염적977례환자작위대조조，대비량조환자적림상자료，분석인공관관절치환술후감염적위험인소급예방대책。결과992례환자인공관관절치환술후공발생감염15례，감염솔위1．51％；검출병원균15주，배전5위병원균의차위금황색포도구균、동록가단포균、대장애희균、표피포도구균、폐염극뢰백균，분별점33．33％、20．00％、20．00％、13．33％、6．67％；환자년령、유기출질병、합병당뇨병、유격소장기응용사、술전혈청백단백급혈홍단백함량저、수술시간급인류시간시인공관관절치환술후감염적위험인소（P＜0．05）。결론인공관관절치환술후감염적원인교다，여환자고령、격소적장기응용、합병다충내과기출질병등인소유관，근거고위인소유침대성적채취상응적예방대책，가강저감염발생솔。
OBJECTIVE To explore the risk factors for postoperative infections in patients undergoing total hip ar‐throplasty and put forward effective prevention countermeasures so as to provide guidance for early prevention and control of the postoperative infections .METHODS The clinical data of 992 patients who underwent the total hip arthroplasty from Jan 2004 to Dec 2012 were retrospectively analyzed;15 patients with infections were assigned as the study group ,and 977 patients without infections were set as the control group;the clinical data were compared between the two groups ,the risk factors for the postoperative infections in the patients undergoing the total hip arthroplasty were analyzed , and the prevention countermeasures were put forward .RESULTS The infections occurred in 15 of 992 patients after the total hip arthroplasty ,with the infection rate of 1 .51% .A total of 15 strains of pathogens have been isolated ,among which the Staphylococcus aureus ,Pseudomonas aeruginosa ,Esch‐erichia coli ,Staphylococcus epidermidis ,and K lebsiella pneumoniae ranked the top five species ,accounting for 33 .33% ,20 .00% ,20 .00% ,13 .33% ,and 6 .67% ,respectively .The risk factors for postoperative infections in the patients undergoing total hip arthroplasty included the age ,underlying disease ,history of long term use of hormones ,low contents of preoperative serum albumin and hemoglobin ,operaiton duration ,and drainage time (P<0 .05) .CONCLUSION There are a variety of risk factors for the postoperative infections in the patients under‐going the total hip arthroplasty ,including the advanced age ,long term use of hormones ,and complication with multiple internal medicine underlying diseases .It is necessary to take targeted prevention countermeasures based on the high risk factors so as to reduce the incidence of infections .