摘要
背景:假体周围感染(PJI)是人工髋膝关节置换术(THA/TKA)后一种少见但是灾难性的并发症,在中国大陆,关于PJI翻修负担的流行病学数据缺乏。目的:本研究旨在回顾性分析北京地区9家医院3年间的感染翻修病例资料并计算翻修负担。方法:回顾性收集2014年1月至2016年12月北京市9家三甲医院关节置换总数及PJI患者的病例资料,分析患者一般资料、感染类型、主要诊断、术前合并疾病、手术方式,计算PJI翻修负担,并描述PJI处理方式及并发症发生情况。结果:此期间共实施髋膝关节置换术38319例次,髋膝关节翻修手术1222例次(总翻修负担3.1%),因PJI翻修366例次(翻修负担0.96%),且总体翻修负担呈逐年下降趋势(1.09%,0.96%,0.84%)。9家医院PJI翻修负担分别为0.78%、0.77%、0.52%、0.77%、0.55%、0.63%、1.24%、0.78%、1.71%。髋关节总体翻修负担为5.60%,其中PJI翻修负担为1.14%,PJI是髋关节翻修的第三大原因;膝关节总体翻修负担为1.77%,其中膝关节PJI翻修负担为0.85%,PJI是膝关节翻修的最常见原因;髋/膝关节PJI患者的手术治疗方式中,二期翻修术分别占75.2%(髋,121/161)和69.8%(膝,143/205),一期翻修术占19.9%(髋,32/161)和6.3%(膝,13/205)、开放清创术占4.3%(髋,7/161)和22.0%(膝,45/205)。结论:2014~2016年北京市9家医院总体髋膝关节翻修负担为3.1%,髋膝关节PJI翻修负担为0.96%;二期翻修术是主要的外科治疗手段。由于随访时间短和病例流失等因素,真正PJI翻修负担可能更高。
Background: Periprosthetic joint infection(PJI) is a rare but devastating complication after total joint arthroplasty.There is paucity of data on the prevalence of PJI in the mainland of China. Objective: To analyze the data of PJI patients in nine class A hospitals from January 2014 to December 2016 and calculate the revision burden due to PJI. Methods: The study involved a retrospective multicenter cross-sectional survey of patients who underwent revisions for PJI after hip/knee arthroplasty in nine hospitals in Beijing from January 2014 to December 2016. The general information of patients, the type of infection, the main diagnosis, preoperative comorbidities and surgical methods were analyzed and the revision burden due to PJI was calculated. The treatment methods and complications were described. Results: There were 38319 cases of hip and knee replacements, 1222 cases of hip and knee revisions(total revision burden 3.1%), and 366 PJI revisions(revision burden 0.96%)during this period. The overall revision burden declined year-by-year(1.09%, 0.96%, 0.84%). The revision burden of PJI in nine hospitals was 0.78%, 0.77%, 0.52%, 0.77%, 0.55%, 0.63%, 1.24%, 0.78%, 1.71%. For hip, the overall revision burden was 5.60%, of which PJI revision burden was 1.14%, and PJI was the third reason for hip revision. For knee, the total revisionburden was 1.77%, of which PJI revision burden was 0.85%, and PJI was the most common cause for knee revision. Among hipand knee PJI revision methods, two-stage revision accounted for 75.2%(hip,121/161) and 69.8%(knee,143/205), and one-stage revision accounted for 19.9%(hip,32/161) and 6.3%(knee,13/205), open debridement accounted for 4.3%(hip,7/161)and 22.0%(knee,45/205). Conclusions: From 2014 to 2016, the total revision burden of nine hospitals in Beijing is 3.1%, andthe revision burden of PJI is 0.96%. The second-stage revision is the main surgical method. Due to the short follow-up timeand case loss, the true PJI revision burden may be higher.
作者
彭慧明
王龙超
陈继营
周一新
田华
林剑浩
郭万首
林源
曲铁兵
郭艾
曹永平
翁习生
PENG Huiming;WANG Longchao;CHEN Jiying;ZHOU Yixin;TIAN Hua;LIN Jianhao;GUO Wanshou;LIN Yuan;QU Tiebing;GUO Ai;CAO Yongping;WENG Xisheng(Department of Orthopaedies,Peking Union Medieal College Hospital,CAMS&PUMC,Beijing 100730;Department of Orthopaedies,Guangdong Provincial People's Hospital,Guangzhou 510080;Department of Orthopaedies,Chinese PLA General Hospital,Beijing 100853;Department of Orthopaedies,Beijing Jishuitan Hospital,Beijing 100035;Department of Orthopaedics,Peking University Third Hospital,Beijing 100083;Department of Orthopaedies,Peking University People's Hospital,Beijing 100044;Department of Orthopaedics,Sino-Japanese Friendship Hospital,Beijing 100029;Department of Orthopaedies,Beijing Chaoyang Hospital,Capital Medieal University,Beijing 100020;Department of Orthopaedies,China Rehabilitation Research Center Beijing Boai Hospital,Beijing 100068;Department of Orthopaedics,Beijing Friendship Hospital,Capital Medieal University,Beijing 100050;Department of Orthopaedics,Peking University First Hospital,Beijing 100034,China)
出处
《中华骨与关节外科杂志》
2020年第4期277-283,共7页
Chinese Journal of Bone and Joint Surgery
关键词
关节成形术
髋膝
感染
翻修
负担
Hip and Knee Arthroplasty
Infection
Revision
Burden
作者简介
第一作者:彭慧明;第一作者:王龙超;通信作者:陈继营,E-mail:chenjy301@aliyun.com;通信作者:周一新,E-mail:orthoryixing@yahoo.com;通信作者:翁习生,E-mail:xshweng@medmail.com.cn
