CAJ | 학술논문

目的：探讨股骨颈骨折髋关节置换术后医院感染流行病学特征及危险因素，为制定预防感染措施提供参考。方法回顾性分析2009年1月－2014年10月在医院行股骨颈骨折髋关节置换术的1000例患者临床资料，记录医院感染率、感染部位，并分析导致医院感染的危险因素，采用SPSS16．0统计软件进行检验，多因素分析采用 logistic回归方法。结果共有36例患者发生医院感染，医院感染率为3．6％；感染部位主要以手术切口为主，共15例占41．7％；共培养出58株病原菌，以革兰阴性菌为主，共44株占75．9％；logistic回归分析显示，住院时间、手术方式、抗菌药使用种类、导管留置时间是导致术后医院感染的独立危险因素（P＜0．05）。结论股骨颈骨折髋关节置换术后医院感染病原菌主要是革兰阴性菌，住院时间、手术方式、抗菌药使用种类、导管留置时间是导致关节置换术后医院感染的独立危险因素。
목적：탐토고골경골절관관절치환술후의원감염류행병학특정급위험인소，위제정예방감염조시제공삼고。방법회고성분석2009년1월－2014년10월재의원행고골경골절관관절치환술적1000례환자림상자료，기록의원감염솔、감염부위，병분석도치의원감염적위험인소，채용SPSS16．0통계연건진행검험，다인소분석채용 logistic회귀방법。결과공유36례환자발생의원감염，의원감염솔위3．6％；감염부위주요이수술절구위주，공15례점41．7％；공배양출58주병원균，이혁란음성균위주，공44주점75．9％；logistic회귀분석현시，주원시간、수술방식、항균약사용충류、도관류치시간시도치술후의원감염적독립위험인소（P＜0．05）。결론고골경골절관관절치환술후의원감염병원균주요시혁란음성균，주원시간、수술방식、항균약사용충류、도관류치시간시도치관절치환술후의원감염적독립위험인소。
OBJECTIVE To explore the epidemiological characteristics of postoperative nosocomial infections in the femoral neck fracture patients undergoing hip arthroplasty and analyze the risk factors so as to provide guidance for prevention of infections .METHODS A total of 1 000 femoral neck fracture patients who underwent the hip arthro‐plasty from Jan 2009 to Oct 2014 were enrolled in the study ,the clinical data of the patients were retrospectively analyzed ,the incidence of nosocomial infections and infection sites were recorded ,and the risk factors for the nos‐ocomial infections were observed .The statistical analysis was performed with the use of SPSS16 .0 software ,and the multivariate logistic regression analysis was carried out .RESULTS The nosocomial infections occurred in 36 patients with the incidence rate of 3 .6% ,of whom 41 .7% (15 cases) had the surgical incision infections .Totally 58 strains of pathogens have been cultured ,among which the gram‐negative bacteria were dominant ,accounting for 75 .9% (44 strains) .The logistic regression analysis indicated that the length of hospital stay ,types of surger‐y ,types of antibiotics ,and catheter indwelling time were the independent risk factors for the postoperative nosoco‐mial infections in the patients undergoing hip arthroplasty (P<0 .05) .CONCLUSION The gram‐negative bacteria are the predominant pathogens causing the postoperative nosocomial infections in the femoral neck fracture patients undergoing hip arthroplasty .The independent risk factors for the postoperative nosocomial infections in the pa‐tients undergoing hip arthroplasty include the length of hospital stay ,types of surgery ,types of antibiotics ,and catheter indwelling time .