石 磊,李海峰,阮狄克,何 勍.脊柱术后手术部位感染的危险因素分析[J].中国脊柱脊髓杂志,2017,(10):908-912.
脊柱术后手术部位感染的危险因素分析
中文关键词:  脊柱手术  手术部位感染  危险因素  Logistic回归分析
中文摘要:
  【摘要】 目的:分析脊柱术后手术部位感染的危险因素,总结降低脊柱术后手术部位感染发生率的经验。方法:收集我科自1995年1月~2015年12月实施脊柱开放手术患者的资料,对文献中常见脊柱术后感染高危因素高龄、糖尿病、肥胖、长手术时间、内固定置入、输血、长期吸烟史、类固醇激素服用史、全身其他部位感染、脑脊液漏、二次手术、后路手术等进行统计并行单因素卡方检验,筛选出阳性危险因素,对阳性危险因素进行多因素Logistic回归分析。结果:共有3964例患者实施脊柱开放手术,术后36例发生手术部位感染,其中男9例,女27例;年龄16~76岁(61.2±3.6岁)。其中合并糖尿病者12例,全身其他部位感染(包括慢性感染)3例,类固醇激素服用史(自身免疫性、代谢性疾病)1例。单因素卡方检验提示高龄、糖尿病、肥胖、长手术时间、内固定置入、输血是脊柱术后感染相关阳性危险因素。长期吸烟史、类固醇激素服用史、全身其他部分感染、脑脊液漏、二次手术、后路手术与脊柱术后感染无相关性。多因素Logistic回归分析提示:高龄、糖尿病、输血、内固定置入及长手术时间会增加脊柱术后手术部位感染的风险,其中长时间手术、肥胖、输血导致脊柱术后手术部位感染的风险最高,其次是糖尿病和内固定置入,而高龄在所有阳性危险因素中导致脊柱术后手术部位感染的风险最小。结论:肥胖、高龄、糖尿病、输血、内固定置入及长手术时间会增加脊柱术后手术部位感染的发生风险。对于有相关危险因素的患者,应尽早控制相关危险因素,加强围手术期预防以降低脊柱术后手术部位感染的风险。
The risk factors of postoperative infection in spinal surgery
英文关键词:Spinal operation  Surgical site infection  Risk factors  Logistics analysis
英文摘要:
  【Abstract】 Objectives: To analyze the risk factors of postoperative infection in spinal surgery, and to explore how to control it. Methods: Patients who accepted spinal open surgery between January 1995 and December 2015 were reviewed, Chi-square test was used to analyze the related influencing factors(age, BMI, smoke, diabetes, other parts of infection, steroid hormones, operation time, cerebrospinal fluid leakage, second operation, internal fixation, posterior approach) of postoperative infection in spinal surgery, multiple Logistic regressions were used to analyze the positive risk factors. Results: All of 3964 patients with spinal open surgery were reviewed, among whom 36 cases including 9 males and 27 females were diagnosed with postoperative infection, age ranged from 16 years to 76 years, the average age was 61.2±3.6 years. Among them, 12 patients were diagnosed with diabetes, 3 patients were diagnosed with chronic infection, one patient had a history of taking steroid hormone drugs. The results of chi-square test showed that elder age, diabetes, obesity, long operation time, instrumentation, blood transfusion might increase the risk of spinal surgical infection, but not long-term smoking, steroids use, other parts of infection, cerebrospinal fluid leakage, second surgery, posterior surgery did not. Multiple Logistic regressions results showed that obesity, elder age, diabetes, instrumentation, blood transfusion and long operation time might increase the risk the spinal surgical infection, and the highest risk factors were obesity, blood transfusion and long operation time. Conclusions: Obesity, elder age, diabetes, instrumentation, blood transfusion and long operation time may increase the risk of spinal surgical infection. Related risk factors should be controlled to reduce the incidence of spinal surgical infection.
投稿时间:2017-03-27  修订日期:2017-08-11
DOI:
基金项目:
作者单位
石 磊 海军总医院骨科 100048 北京市 
李海峰 海军总医院骨科 100048 北京市 
阮狄克 海军总医院骨科 100048 北京市 
何 勍  
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