摘要
目的探讨腰椎后路内固定手术后,发生早期切口深部感染的危险因素。方法回顾性分析2012-06-2015-06采用后路手术治疗的310例患者临床资料,其中发生早期切口深部感染13例。统计所有患者的相关资料,包括年龄、性别、内科合并症(高血压和糖尿病)、手术前后的白蛋白、血红蛋白水平、手术节段数量、手术时间和术中出血量、有无输血、抗生素使用时间和引流管的放置时间等指标,将上述各项指标作为因变量,将出现术后早期切口深部感染与否作为自变量,进行危险因素分析。结果单因素分析显示,高血压、有无输血、年龄、术后血红蛋白、手术节段、手术时间、出血量和引流管放置时间均是与切口深部感染相关的影响因素;多因素Logistic回归分析提示,引流管放置时间(OR=1.827,P=0.027)以及手术节段(OR=3.236,P=0.012)是导致术后切口深部感染的独立危险因素。结论在临床实际中,60岁以上的老年患者术前应注意将血压控制在良好状态,术后应积极纠正其血红蛋白水平;对于手术节段较多者,应提高手术技巧,尽量缩短手术时间,降低出血量,同时应注意对术后引流管的无菌防护措施。
Objective To investigate the risk factors of early postoperative deep infection after lumbar posterior internal fixation. Methods The clinical data of 310 patients who underwent posterior surgery from June 2012 to June 2015 were retrospectively analyzed. Among them, there were 13 cases with deep incision infection in the early stage of the disease. The data of all patients, including age, gender, medical comorbidities (hypertension and diabetes), albumin, hemoglobin levels before and after surgery, surgical segment number, operation time and intraoperative bleeding, blood transfusion, antibiotic use time and drainage tube time indicators were analyzed. These indicators were selected as dependent variables, and whether appeared early postoperative incision deep infection was selected as independent variables, the risk factors were analyzed. Results Univariate analysis showed that hypertension, blood transfusion, age, postoperative hemoglobin, surgical segment, operation time, bleeding volume and time of drainage tube were the related factors of deep wound infection. Multivariate Logistic regression analysis showed that the drainage tube placement time(OR=l.827, P=0.027) and operation segments(OR=3.236,P--O.O12) were the leading independent risk factors. Conclusion In clinical practice, we should pay attention to blood pressure control in good condition of elderly patients older than 60 years, after the operation should actively correct the hemoglobin level; as for the surgical segment more, should improve the operation skills,try to shorten the operation time, reduce the amount of bleeding at the same time, we should pay attention to aseptic protective measures for drainage tube after the operation.
作者
范一鸣
王征
王岩
FAN Yi-ming WANG Zheng WANG Yan(Department of Orthopedics, General Hospital of Chinese PLA, Beijing, 100039,China)
出处
《颈腰痛杂志》
2017年第4期327-330,共4页
The Journal of Cervicodynia and Lumbodynia