背景:初次全髋关节置换术(THR)中的假体周围感染(PJI)是骨科手术中最重要的威胁之一,因此,外科医生的一个重要目标是避免或早期诊断PJI。虽然我们部门的PJI发病率很低(0.69%),平均随访595d,由于治疗困难和愈合后较低的功能结局,这种感染构成了严重威胁.
目的:研究我们部门2016年发生的所有手术中PJI的发生率,以寻找潜在感染的预测性迹象。
方法:我们统计了578例患者的583例THR,仅观察到4例感染(0.69%),平均随访596d(min30,max1451)。我们审查了所有医疗记录以收集数据:手术的持续时间和时间,存在,抗生素治疗的类型和持续时间,术前诊断,手术前后的血液值,输血,术前药物的存在(特别是抗凝剂和抗凝剂,皮质类固醇和免疫抑制剂),存在一些合并症(高体重指数,血液高血压,慢性阻塞性肺疾病,心肌缺血,糖尿病,风湿病,以前的局部感染)。
结果:没有术前,术中,或术后分析显示PJI的发生率较高.我们没有找到任何具有明显的PJI重大赔率的班级。在我们的研究中,我们没有发现任何预测PJI的边界值,两组(非PJI和PJI)中所有患者的值相似.只有一些类别,比如女性患者,显示了更多的PJI频率,但这一与性别相关的差异并无统计学意义。
结论:我们没有发现THR中PJI风险较高的类别,可能是由于很少有感染病例。
BACKGROUND: Periprosthetic joint infection (PJI) in primary total hip replacement (THR) is one of the most important threats in orthopedic surgery, so one important surgeon\'s target is to avoid or early diagnose a PJI. Although the incidence of PJI is very low (0.69%) in our department, with an average follow-up of 595 d, this infection poses a serious threat due to the difficulties of treatment and the lower functional outcomes after healing.
OBJECTIVE: To study the incidence of PJI in all operations occurring in the year 2016 in our department to look for predictive signs of potential infection.
METHODS: We counted 583 THR for 578 patients and observed only 4 cases of infection (0.69%) with a mean follow-up of 596 d (min 30, max 1451). We reviewed all medical records to collect the data: duration and time of the surgery, presence, type and duration of the antibiotic therapy, preoperative diagnosis, blood values before and after surgery, transfusions, presence of preoperative drugs (in particularly anticoagulants and antiaggregant, corticosteroids and immunosuppressants), presence of some comorbidities (high body mass index, blood hypertension, chronic obstructive pulmonary disease, cardiac ischemia, diabetes, rheumatological conditions, previous local infections).
RESULTS: No preoperative, intraoperative, or postoperative analysis showed a higher incidence of PJI. We did not find any class with evident major odds of PJI. In our study, we did not find any border value to predict PJI and all patients had similar values in both groups (non-PJI and PJI). Only some categories, such as female patients, showed more frequency of PJI, but this difference related to sex was not statistically significant.
CONCLUSIONS: We did not find any category with a higher risk of PJI in THR, probably due to the lack of few cases of infection.