Buehrer J L, Weber D J, Meyer A A, Becherer P R, Rutala W A, Wilson B, Smiley M L, White G C
Department of Surgery, University of North Carolina, Chapel Hill 27599-7030.
Ann Surg. 1990 Apr;211(4):492-8. doi: 10.1097/00000658-199004000-00018.
One-hundred and two patients with hemophilia A, hemophilia B, or acquired antibody to factor VIII who had undergone invasive procedures were cross referenced with patients participating in an ongoing prospective natural history study of HIV-1 infection in hemophiliacs. Matching revealed that HIV-1 status was known for 83 patients (83%) who had undergone 169 procedures between July 1979 and April 1988. Invasive procedures were classified as clean in 108 patients (63.9%), clean-contaminated in 45 (26.6%), contaminated in 2 (1.2%), and infected in 14 (8.3%). Wound infection rates by HIV-1 status were as follows (95% confidence intervals): HIV+ 1.4% (0% to 5%), HIV- 0% (0% to 9%), and procedure before testing HIV+ 1.5% (0% to 6%). There were no significant differences between the wound infection rates of HIV-positive and HIV-negative hemophiliacs nor in the wound infection rate among all three subgroups of patients (p greater than 0.5, Fisher's Exact Test). We conclude that surgery in HIV-1-infected patients who have not progressed to AIDS does not entail an increased risk of postoperative wound infections.
102例患有甲型血友病、乙型血友病或获得性抗凝血因子VIII抗体且接受过侵入性操作的患者,与参与一项正在进行的血友病患者HIV-1感染前瞻性自然史研究的患者进行了交叉对照。匹配结果显示,在1979年7月至1988年4月期间接受过169次操作的83例患者(83%)的HIV-1状态已知。侵入性操作被分类为清洁的有108例患者(63.9%),清洁-污染的有45例(26.6%),污染的有2例(1.2%),感染的有14例(8.3%)。按HIV-1状态划分的伤口感染率如下(95%置信区间):HIV阳性1.4%(0%至5%),HIV阴性0%(0%至9%),检测前HIV阳性的操作1.5%(0%至6%)。HIV阳性和HIV阴性血友病患者的伤口感染率之间以及所有三个患者亚组的伤口感染率之间均无显著差异(p>0.5,Fisher精确检验)。我们得出结论,未进展至艾滋病的HIV-1感染患者进行手术不会增加术后伤口感染的风险。