项晟煜 黄冬红

[摘要] 目的 探讨分析人工关节置换术患者并发症危险因素分析及护理效果。 方法 收集2012年1月～2014年1月于浙江省中医院（以下简称“我院”）接受人工关节置换术40例患者的临床资料，采用单因素分析和多因素Logistic回归分析分析人工关节置换术术后发生并发症的危险因素。另选取2014年3月～2015年3月我院经人工关节置换术后出现并发症70例患者，随机分为实验组和对照组，每组各35例，给予对照组患者常规护理，针对独立危险因素给予实验组患者围术期的护理干预，对两组患者的术后并发症发生率情况进行比较。 结果 单因素分析结果显示，术后并发症发生与术前合并症、肢体制动时间过长、细菌交叉感染、住院时间有关（P < 0.05）；多因素Logistic回归分析结果表明，存在术前的合并症（OR = 4.967，95%CI：1.217～20.376，P = 0.010）、住院的时间>15 d（OR = 5.217，95%CI：2.692～10.175，P = 0.000）、存在细菌交叉感染（OR = 5.657，95%CI：2.487～12.892，P = 0.014）、肢体制动的时间过长（OR = 6.318，95%CI：3.252～12.299，P = 0.021）为人工关节置换术后患者并发症发生的独立危险因素。接受围术期的护理干预后，实验组患者并发症的发生率（14.29%）较对照组（51.43%）显著降低，差异有高度统计学意义（P < 0.01）。 结论 围术期的针对性护理能够显著帮助减少人工关节置换术术后患者的并发症发生率，具一定的临床推广价值。

[关键词] 人工关节置换术；并发症；危险因素；护理

[中图分类号] R687.4 [文献标识码] A [文章编号] 1673-7210（2015）06（b）-0120-04

Analysis of the risk factors of complications in patients with prosthetic joint replacement and the nursing effect

XIANG Shengyu1 HUANG Donghong2

1.Service Centre， Beilun District People's Hospital of Ningbo City， Zhejiang Province， Ningbo 315800， China； 2. Department of Orthopaedics， the TCM Hospital of Zhejiang Province， Zhejiang Province， Hangzhou 310002， China

[Abstract] Objective To explore the risk factors of complications in patients with prosthetic joint replacement and the nursing effect. Methods The clinical data of 42 patients with prosthetic joint replacement from January 2012 to January 2014 in the TCM Hospital of Zhejiang Province （"our hospital" for short ） were collected， single factor analysis and Logistic regression analysis were uesd to analyze risk factors of complication after prosthetic joint replacement. And 70 patients with complications after prosthetic joint replacement in our hospital from March 2014 to March 2015 were selected and divided into the experimental group and control group， with 35 cases in each group. The patients in control group were given the routine nursing， and patients in experimental group were given perioperative period nursing according to the risk factors. The complications incidence between two groups were compared. Results The single factor analysis showed postoperative complications were connected with preoperative complications， bacteria cross infection， limbs braking time too long， hospital stays （P < 0.05）. Logistic regression analysis showed postoperative complications （OR = 4.967， 95%CI：1.217-20.376， P = 0.010）， hospital stays > 15 d （OR = 5.217， 95%CI： 2.692-10.175， P = 0.000）， bacteria cross infection （OR = 5.657， 95%CI： 2.487-12.892， P = 0.014）， limbs braking time too long （OR = 6.318， 95%CI： 3.252-12.299， P = 0.021） were independent risk factors of complications after prosthetic joint replacement. The complications incidence of experimental group （14.29%） was much lower than that of control group （51.43%）， the difference was statistically significant （P < 0.01）. Conclusion Perioperative targeting nursing can significantly help reduce the rate of complications in patients with prosthetic joint replacement， which is worth for clinical expand.

[Key words] Arthroplasty； Complications； Risk factors； Nursing

人工关节置换术主要是把人工关节的假体经由外科技术以植入患者体内，从而替代患病关节的生理功能，实现缓解患者关节疼痛，基本恢复关节生理功能目的[1-2]。按照保守估计，每年全世界150万以上的患者接受了人工关节的置换手术，相应其术后的并发症发生率也居高不下[3-4]。本研究通过回顾性分析人工关节置换手术患者的临床资……