Xu Guangyong, Zhao Juan, Sun Jie, Liu Yizong
Guangyong Xu, Department of Dermatology, Qingdao No.6 People's Hospital, Qingdao, 266033, China.
Juan Zhao, Department of Dermatology, Qingdao No.6 People's Hospital, Qingdao, 266033, China.
Pak J Med Sci. 2017 Nov-Dec;33(6):1449-1453. doi: 10.12669/pjms.336.13368.
To evaluate the incidence of postoperative infection and fracture nonunion as well as the risk factors for postoperative infection in human immunodeficiency virus (HIV) positive patients.
From May 2013 to March 2016, the HIV positive fracture patients treated surgically in orthopaedics department of our hospital were analyzed retrospectively, and fifty HIV negative fracture patients during the same period were selected as control. The clinical data of included patients were reviewed. The incidence of postoperative infection and fracture nonunion were compared between the two groups, and the risk factors for postoperative infection in HIV positive patients were evaluated.
The incidence of poor wound healing and incision infection in HIV positive group was higher than that in HIV negative group, but there were no significant differences between the two groups (p>0.05). Multivariable regression analysis demonstrated that HIV clinical category (p<0.05), CD4+T-lymphocyte category (p<0.01) and open fracture (p<0.05) were independent risk factors for postoperative wound infections, but age, gender, operation time, incision type, emergency operation, albumin and lymphocyte count were not (p>0.05). There was no significant difference in the rate of nonunion between the two groups (p>0.05).
The incision can be healed, and fracture can be united normally in most of HIV positive patients with fracture, and postoperative wound infections were significantly associated with HIV clinical category, CD4+T-lymphocyte category and open fracture.
评估人类免疫缺陷病毒(HIV)阳性患者术后感染和骨折不愈合的发生率以及术后感染的危险因素。
回顾性分析2013年5月至2016年3月在我院骨科接受手术治疗的HIV阳性骨折患者,并选取同期50例HIV阴性骨折患者作为对照。对纳入患者的临床资料进行回顾。比较两组患者术后感染和骨折不愈合的发生率,并评估HIV阳性患者术后感染的危险因素。
HIV阳性组伤口愈合不良和切口感染的发生率高于HIV阴性组,但两组之间差异无统计学意义(p>0.05)。多变量回归分析表明,HIV临床分类(p<0.05)、CD4+T淋巴细胞分类(p<0.01)和开放性骨折(p<0.05)是术后伤口感染的独立危险因素,但年龄、性别、手术时间、切口类型、急诊手术、白蛋白和淋巴细胞计数不是(p>0.05)。两组之间的不愈合率差异无统计学意义(p>0.05)。
大多数HIV阳性骨折患者的切口可愈合,骨折可正常愈合,术后伤口感染与HIV临床分类、CD4+T淋巴细胞分类和开放性骨折显著相关。