| 王如来,熊敏,周升.腰椎后路融合术后急性手术部位感染的危险因素分析.骨科,2020,11(1): 13-18. |
| 腰椎后路融合术后急性手术部位感染的危险因素分析 |
| The risk factors of acute surgical site infection after posterior lumbar spinal fusion |
| 投稿时间：2019-04-19 |
| DOI：10.3969/j.issn.1674-8573.2020.01.003 |
| 中文关键词: 急性手术部位感染 腰椎后路手术 危险因素 |
| 英文关键词: Acute surgical site infection Posterior lumbar spinal surgery Risk factors |
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| 中文摘要: |
| 目的 探讨腰椎后路融合术后发生急性手术部位感染的相关危险因素。方法 回顾性分析2016年1月至2018年12月于我院脊柱外科行腰椎后路融合手术的330例病人的临床资料。病人主要诊断包括腰椎椎管狭窄、腰椎间盘突出症、腰椎骨折、肿瘤等。根据术后是否发生急性手术部位感染将病人分为感染组和非感染组，选择年龄、性别、身体质量指数（body mass index, BMI）、吸烟、高血压、糖尿病、骨质疏松症、手术节段数、手术时间、出血量、切口长度、术后引流时间、尿路感染和脑脊液漏等可能影响术后急性手术部位感染的因素，先后应用单因素分析和二元Logistic回归分析腰椎后路融合术后急性手术部位感染的危险因素。结果 共有19例术后发生了急性手术部位感染，发生率为5.76%（19/330）。单因素分析结果显示：两组病人的年龄、BMI、糖尿病、骨质疏松、手术节段、手术时间、出血量、脑脊液漏、尿路感染以及切口长度的差异均有统计学意义（P均＜0.05）。二元Logistic回归分析结果显示：BMI[OR=1.429，95% CI（1.059，1.929），P=0.020]、合并糖尿病[OR=9.568，95% CI（2.183，41.935），P=0.003]、手术时间[OR=8.868，95% CI（1.992，39.482），P=0.004]、切口长度[OR=7.257，95% CI（2.937，16.719），P＜0.001]为腰椎后路融合术后急性手术部位感染的独立危险因素。结论 为了降低腰椎术后急性手术部位感染的发生率，围术期应合理评估控制相关危险因素，以获得更好的治疗效果和病人满意度。 |
| 英文摘要: |
| Objective To explore the risk factors of acute surgical site infection following posterior lumbar spinal fusion. Methods A retrospective case-control study of 330 patients following posterior lumbar spinal fusion surgery was performed from January 2016 to December 2018. Diagnoses of the patients included lumbar spinal stenosis, lumbar disc herniation, lumbar vertebrae fracture, lumbar spine tumor. Patients were divided into infected group and non-infected group based on the presence or absence of acute surgical site infection after surgery. The risk factors including age, gender, body mass index (BMI), smoking, hypertension, diabetes, osteoporosis, operative segment, operative time, blood loss, incision length of surgery, days of draining, urinary tract infection and cerebrospinal fluid leakage, which probably influenced the postoperative acute surgical site infection, were selected. Univariate analysis and binary Logistic regression analysis were performed to analyze the risk factors. Results During this period, 19 cases were identified with acute surgical site infection in the study, with a incidence of 5.76% (19/330). Univariate analysis showed that there were significant differences in age, BMI, diabetes, osteoporosis, operative segment, operative time, blood loss, cerebrospinal fluid leakage, urinary tract infection and incision length between two groups (P＜0.05 for all). The binary Logistic regression analysis showed that BMI [OR=1.429, 95% CI(1.059, 1.929), P=0.020], diabetes [OR=9.568, 95% CI(2.183, 41.935), P=0.003], operation time [OR=8.868, 95% CI(1.992, 39.482), P=0.004] and the length of incision [OR=7.257, 95% CI(2.937, 16.719), P＜0.001] were the independent risk factors for acute surgical site infection. Conclusion In order to reduce the incidence of acute surgical site infections following posterior lumbar spinal fusion, the related risk factors of acute surgical site infections following posterior lumbar spinal fusion should be reasonably evaluated and controlled perioperatively to obtain the better curative effectiveness and patient satisfaction. |
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