外科手术部位感染的可控性因素.ppt

Modifiable Risk Factors for Surgical Site Infection手术部位感染的可控性风险因素 The Journal of Bone and Joint Surgery (American). 2011;93:398-404.? Multiple risk factors for orthopaedic surgical site infection, have been identified： including a wide variety of demographic, comorbidity operative, and postoperative variables, 目前已经明确，骨科手术部位的感染包括多方面的风险因素，如各种不同的人群、合并症、手术以及术后相关的因素等 The patient as a host is an important risk factor for infection, and many, if not most, patients are in suboptimal health. 患者作为宿主本身就是感染最重要的风险因素，即使不是大多数，那也有很多患者的健康状况并不理想。 Optimizing the patients medical condition before surgery and eliminating or even diminishing modifiable risk factors for infection (Fig. 1) should lower the risk of surgical site infection. 在手术前将患者的内科情况调整到最佳状态，杜绝或减少感染的可控性风险因素（图1）应该可以降低手术部位感染的风险。 Direct scientific evidence showing that modification of these risk factors will lead to a decrease in surgical site infection is not readily available, and much work in this field remains to be done. 然而，对于控制这些风险因素便可减少手术部位感染的观点，要找到直接的科学证据其实并不简单，在这一领域仍有很多工作有待进一步深入。 It is imperative that surgeons have an extensive knowledge of modifiable risk factors affecting the wound-healing process and subsequent wound complications. 非常必要的是，外科医生应该对影响创口愈合过程以及继发创口并发症的可控性风险因素有一个广泛的认识。 Modifiable Risk Factors for Surgical Site Infection and Possible Preoperative Interventions手术部位感染的可控性风险因素及可能的术前干预措施  Rheumatoid Arthritis Patients with rheumatoid arthritis have an increased risk of infection following orthopaedic procedures. Patients with rheumatoid arthritis who undergo total joint arthroplasty have a two to three times greater risk of acquiring a postoperative surgical site infection than do patients with osteoarthritis. 类风湿性关节炎 患有类风湿性关节炎的患者骨科手术后感染的风险明显增加。 类风湿性关节炎类风湿性关节患者行全关节置换术后发生手术部位感染的风险是骨关节炎患者的2-3倍。 Patients with rheumatoid arthritis are frequently being treated with complex drug regimens that include nonsteroidal anti-inflammatory drugs, corticosteroids, methotrexate, and biologics, all of whi