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Thompson 关节置换术治疗髋部骨折患者术后感染的危险因素。

Risk factors for postoperative infections in patients with hip fracture treated by means of Thompson arthroplasty.

机构信息

Traumatology and Orthopedic Surgery, Area III, Surgery Department, Faculty of Medicine, University of Zaragoza, c/Domingo Miral s/n, Zaragoza 50.009, Spain.

出版信息

Arch Gerontol Geriatr. 2010 Jan-Feb;50(1):51-5. doi: 10.1016/j.archger.2009.01.009. Epub 2009 Feb 23.

Abstract

Specific conditions associated with surgery may predispose elderly people to septic complications after hip fracture surgery. This study investigated the risk factors predisposing infection in aged patients with subcapital hip fracture. We performed a prospective study of 290 patients with displaced subcapital hip fracture, operated by means of Thompson hip hemi-arthroplasty (83.5% fractures in women). The mean age was 85.42+/-6.06 years (ranging from 69 to 104). Follow-up was realized until death or at least for 2 years. The chi(2) test, analysis of variance, Kruskal-Wallis test, correlation analysis and the Spearman test were applied. Odds ratios (OR) were calculated. During the hospital stay, there were diagnosed 94 urinary tract infections, 25 pneumonias, 50 superficial wound infections, 11 deep wound infections. Transfusions were made in 120 patients (in average: 2.54+/-1.45 units of red cell concentrate/transfused patient). Transfusion appeared to be correlated with superficial wound infection (OR=1.96), urinary infection (OR=1.76) and pneumonia (OR=2.85). Higher number of days waiting for surgery were related significantly with pneumonia (9.8+/-7.44 days vs. 6.39+/-3.75), or urinary tract infection (7.76+/-4.39 days vs. 6.17+/-4.14). We concluded that the transfusion and longer waiting time for surgery have been associated with the septic complications in elderly patients treated surgically for hip fracture.

摘要

特定与手术相关的情况可能使老年髋部骨折手术后易发生脓毒症并发症。本研究调查了导致老年股骨颈骨折患者感染的易感因素。我们对 290 例移位性股骨颈骨折患者进行了前瞻性研究,采用 Thompson 髋关节半髋关节成形术(83.5%为女性骨折)进行治疗。平均年龄为 85.42+/-6.06 岁(年龄范围为 69 至 104 岁)。随访至死亡或至少 2 年。应用卡方检验、方差分析、Kruskal-Wallis 检验、相关分析和 Spearman 检验。计算比值比(OR)。在住院期间,诊断出 94 例尿路感染、25 例肺炎、50 例浅表伤口感染、11 例深部伤口感染。120 例患者接受输血(平均:2.54+/-1.45 单位浓缩红细胞/输血患者)。输血与浅表伤口感染(OR=1.96)、尿路感染(OR=1.76)和肺炎(OR=2.85)相关。手术等待时间较长与肺炎(9.8+/-7.44 天比 6.39+/-3.75)或尿路感染(7.76+/-4.39 天比 6.17+/-4.14)显著相关。我们得出结论,输血和手术等待时间延长与接受手术治疗的老年髋部骨折患者的脓毒症并发症有关。

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