發(fā)布時(shí)間：2018-05-14 03:26

  本文選題：人工股骨假體 + 病原菌�。� 參考：《中華醫(yī)院感染學(xué)雜志》2017年23期

【摘要】：目的探究采用醫(yī)用CT技術(shù)結(jié)合計(jì)算機(jī)輔助設(shè)計(jì)重建個(gè)性股骨假體并進(jìn)行置換術(shù)后感染病原菌的分布、耐藥性、感染部位及危險(xiǎn)因素。方法選取2011年7月-2016年6月于醫(yī)院接受股骨假體置換術(shù)的患者202例,回顧患者的臨床資料,個(gè)性化分析股骨假體置換術(shù)后感染的危險(xiǎn)因素,經(jīng)無(wú)菌操作,對(duì)感染患者標(biāo)本進(jìn)行病原菌培養(yǎng)、分離和鑒定,并經(jīng)藥敏試驗(yàn)了解其耐藥性。結(jié)果股骨假體置換術(shù)的202例患者中有36例感染患者,感染率為17.82%;36例股骨假體置換術(shù)感染患者分離出病原菌46株,以革蘭陽(yáng)性菌為主,共31株占67.39%;主要革蘭陽(yáng)性菌對(duì)青霉素、頭孢克洛、頭孢呋辛、頭孢唑林的耐藥率較高,均≥50.00%,對(duì)萬(wàn)古霉素的耐藥率較低;Logistic多元回歸分析結(jié)果顯示,年齡、手術(shù)時(shí)間、術(shù)中輸血量、引流時(shí)間、是否長(zhǎng)期使用抗菌藥物、血紅蛋白、血清白蛋白是股骨假體置換術(shù)后感染的獨(dú)立危險(xiǎn)因素(P0.05)。結(jié)論個(gè)性股骨假體置換術(shù)后患者的感染病原菌以革蘭陽(yáng)性菌為主,且耐藥率較高。
[Abstract]:Objective to investigate the distribution, drug resistance, infection site and risk factors of the infection pathogens after the reconstruction of individual femoral prosthesis by medical CT and computer aided design. Methods 202 patients undergoing femoral prosthesis replacement were selected from July 2011 to June 2016. The clinical data of the patients were reviewed and the risk factors of infection after femoral prosthesis replacement were analyzed. The pathogens of infected patients were cultured, isolated and identified, and their drug resistance was determined by drug sensitivity test. Results among 202 cases of femoral prosthesis replacement, 36 cases were infected, and the infection rate was 17.82%. 46 strains of pathogenic bacteria were isolated from 36 cases of femoral prosthesis replacement, 31 strains were Gram-positive bacteria (67.39%), and the main gram-positive bacteria were penicillin. The drug resistance rate of cefaclor, cefuroxime and cefazolin was higher than that of cefazolin. The results of logistic multivariate regression analysis showed that age, operation time, intraoperative blood transfusion, drainage time and long-term use of antibiotics were lower than those of vancomycin resistance. Hemoglobin and serum albumin were the independent risk factors of infection after femoral prosthesis replacement. Conclusion Gram-positive bacteria are the main pathogenic bacteria in patients with personality femoral prosthesis replacement, and the drug resistance rate is higher.
【作者單位】： 十堰市太和醫(yī)院湖北醫(yī)藥學(xué)院附屬醫(yī)院骨科;湖北醫(yī)藥學(xué)院計(jì)算機(jī)教研室;湖北醫(yī)藥學(xué)院附屬東風(fēng)醫(yī)院骨科;
【基金】：湖北省科技計(jì)劃基金資助項(xiàng)目(2015CFC808)
【分類(lèi)號(hào)】：R446.5;R687.3

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