RÉSUMÉ
Objective To investigate the incidence of surgical site infection (SSI)in patients undergoing orthopedic surgery,analyze the risk factors,and provide basis for the prevention and control of SSI.Methods All hospitalized orthopedic patients undergoing surgery in a hospital from January 2010 to December 2014 were retrospectively sur-veyed,questionnaires were designed,patients’medical records were reviewed,incidence of SSI was analyzed,risk factors for SSI were analyzed with univariate and logistic regression methods.Results A total of 14 300 orthopedic patients undergoing surgery were investigated,576 (4.03%)patients had SSI,predominantly were superficial inci-sion infection (n=429,74.48%),615 strains of pathogenic bacteria were isolated from 576 patients,mainly were Staphylococcus aureus (n=137,22.28%),Escherichia coli (n=84,13.66%),and Enterobacter cloacae (n=73, 11 .87%).The incidence of SSI decreased year by year in patients undergoing orthopedics surgery(χ2 =24.706,P <0.001);the incidence of SSI in patients with amputation was the highest (22.67%),followed by patients with de-bridement (7.16%);multivariate logistic regression analysis indicated that long duration of operation,long length of hospital stay,underlying diseases,use of implants,contaminated incision,more intraoperative blood loss,irra-tional perioperative use of antimicrobial agents,and without using negative pressure drainage were independent risk factors for SSI in patients undergoing orthopedic surgery.Conclusion The incidence of SSI is high in orthopedic pa-tients undergoing surgery,effective preventive measures should be actively taken according to the related risk factors of SSI,so as to reduce the occurrence of SSI.
RÉSUMÉ
Objective To investigate the factors that affecting the efficacy of arthroscopic debridement in the treatment of knee osteoar-thritis. Methods The clinical data of patients with knee osteoarthritis treated with arthroscopic debridement in our hospital from January 2009 to December 2013 was retrospectively analyzed,and the treatment effect was evaluated by Lysholm score. The factors that may affect the efficacy were selected to make a single factor analysis,and then made a multiple logistic regression analysis with the factors which were of sta-tistical significance through single factor analysis. Results Single factor analysis showed that age,course of disease,body mass index,psycho-logical factor,preoperative VAS score,preoperative Kellgren-Lawrence grade,preoperative Lysholm score and postoperative rehabilitation exer-cise were the factors that affected the efficacy of knee arthroscopy in the treatment of knee osteoarthritis,and the difference between the two groups was statistically significant. Further multivariate analysis showed that high body mass index,high preoperative VAS pain score,low Ly-sholm score,high psychological expectations and high preoperative Kellgren-Lawrence grading were expected to be the independent risk fac-tors of knee arthroscopy in the treatment of knee osteoarthritis. Strict compliance with the postoperative rehabilitation exercise was the protect factor. Conclusion High body mass index,high preoperative VAS pain score,low preoperative Lysholm score,high preoperative Kellgren-Lawrence grading,and high psychological expectations were expected to reduce the effect of surgery,while strict compliance with the postoper-ative rehabilitation exercise can improve the curative effect.
RÉSUMÉ
Objective To explore the clinical efficacy of polyetheretherketone( PEEK) cages and titanium cages combined with pedicle screw fixation operation in treatment of lumbar degenerative disease,and provide reference for clinic. Methods The data of 50 patients with lumbar degenerative disease in our hospital from March 2011 to March 2013 were retrospectively analyzed. All patients were treated with pos-terior decompression,bone graft and transpedicular screw internal fixation,according to the different cages,they were divided into PEEK group and titanium group. The PEEK group with 25 patients used polyetheretherketone cages,and the titanium group with 25 patients used titanium cages. The JOA scores of patient before surgery,1 month,6 months and 1 year after surgery between two groups were recorded and compared. The ROM of fusion levels and adjacent segment of patients before and after operation between two groups were compared. Results There was no statistical significance of difference in JOA score,Oswestry score and fusion rate between two groups(P>0. 05). There were statistical significance of differences intervertebral disc height change between 2 groups(P<0. 05). The ROM of fusion levels and adjacent segment of patients in PEEK group was better than those in titanium group(P<0. 05). Conclusion The polyetheretherketone cages combined with pedicle screw fixation operation have a good effect in the treatment of patients with lumbar degenerative disease,especially in matter of lumbar spinal motion and intervertebral height lost.
RÉSUMÉ
Objective: To explore the therapeutic effect of early rehabilitation on aged patients with acute myocardial infarction (AMI) complicated heart failure (HF). Methods: According to number table method, a total of 168 AMI cases were randomly divided into early rehabilitation group (n=84, received early rehabilitation protocol) and routine treatment group (n=84, received traditional treatment). Incidence rate of complication, bicycling test and walking test result were compared between two groups at the end of rehabilitation program. Results: There were no significant difference in angina pectoris after myocardial infarction, re-infarction, dead cases during hospitalization and left ventricular ejection fraction （LVEF）etc. between two groups (P>0.05 all). Compared with routine treatment group, there were significant rise in completion rates of bicycling test (77.6% vs. 95.0%) and walking test (65.4% vs. 95.8%) at the end of program in early rehabilitation group, P<0.01 both. Incidence rates of complications caused by long-term lying in bed in early rehabilitation group were significantly lower than those of routine treatment group (P<0.05 or P<0.01). Conclusion: It’s safe and beneficial to perform early rehabilitation protocol in aged patients with acute myocardial infarction complicated heart failure (35%