前列腺增生与全髋置换假体周围感染相关分析

Correlation between symptomatic benign prostatic hyperplasia and periprosthetic infection secondary to total hip arthro⁃ plasty in male adult

摘要:

［目的］ 探讨症状性良性前列腺增生与初次全髋关节置换 （total hip arthroplasty, THA） 术后假体周围感染 （peripros- thetic joint infection, PJI）的相关性。［方法］2011 年 1 月—2018 年 12 月在本院行初次 THA 的男性患者 133 例纳入本研究，根据随访过程中是否确认 PJI，将患者分为两组，行单项因素比较和二元多因素逻辑回归分析。［结果］ 133 患者术后随访 24 个月以上，平均 （5.80±1.77） 年。依据 2013 年 MSIS 的 PJI 诊断标准，10 例患者随访过程中确认 PJI，占 8.13%；平均 PJI 发生时间为初次术后（6.12±2.91）个月，感染患者均采用后外侧入路。单项因素比较表明，PJI 组合并糖尿病的比率、合并症状性良性前列腺增生 （symptomatic benign prostatic hyperplasia, SBPH） 的比率、术后放置引流管的比率、术后泌尿系感染的比率、 BMI、术后引流量和放置引流时间显均著大于非 PJI 组 （P<0.05）；但是，PJI 组术前白蛋白水平显著低于非 PJI 组 （P<0.05）。 两组年龄、侧别、术前血沉、术前 WBC、术前 D-二聚体、手术时间、输血量及麻醉方式的差异均无统计学意义 （P>0.05）。 二元多因素逻辑回归分析表明，合并 SBPH （OR=3.267， P<0.05）、合并糖尿病 （OR=2.482，P<0.05） 及术后尿路感染 （OR= 2.542，P<0.05）是 PJI 发生的危险因素。［结论］本研究表明 SBPH 是初次 THA 术后发生 PJI 的独立危险因素。

Abstract:

[Objective] To investigate the correlation between symptomatic benign prostatic hyperplasia (SBPH) and periprosthetic joint infection (PJI) secondary to primary total hip arthroplasty (THA) . [Methods] A total of 133 male patients who underwent primary THA in our hospital from January 2011 to December 2018 were included in this study. According to whether PJI was confirmed during the fol- low-up, the patients were divided into two groups. Univariate comparison and binary multiple logistic regression analysis were conducted to search the factors related to PJI. [Results] All the 133 patients were followed up for more than 24 months, with an average of (5.80±1.77) years. According to the PJI diagnostic criteria of MSIS in 2013, 10 patients were confirmed as PJI during follow-up, accounting for 8.13% with a mean PJI occurrence time of (6.12±2.91) months after the primary operation, and all infected patients adopted posterolateral ap- proach. As consequence of univariate comparison, the PJI group had significantly higher ratios of comorbidity of diabetes, SBPH, postoper- ative drainage placement, postoperative urinary tract infection, as well as significantly higher BMI, postoperative drainage volume and drainage time than the non-PJI group (P＜0.05) , whereas the former had significantly lower preoperative albumin level than the latter (P＜ 0.05) . There were no significant differences between the two groups in terms of age, side, preoperative ESR, preoperative WBC, preopera- tive D-dimer, operation time, transfusion volume and anesthesia mode between the two groups (P＞0.05) . As results of logistic regression, comorbidity of SBPH (OR=3.267, P＜0.05) , comorbidity of diabetes mellitus (OR=2.482, P＜0.05) , and postoperative urinary tract infection (OR=2.542, P＜0.05) were independent risk factors for PJI. [Conclusion] SBPH is an important independent risk factor for PJI after primary THA.