摘要
目的总结分析颈椎后路单开门术后切口感染的相关因素,为临床实践提供参考。方法回顾性分析2000年1月至2017年6月收治的颈椎后路单开门术后切口感染病例共26例,按照1∶2的比例随机选取同时期未感染病例52例作为对照组,单因素分析患者年龄、性别、体质指数(BMI)、是否合并糖尿病、吸烟饮酒史、营养状况(血清总蛋白、血清白蛋白)、术前预防应用抗生素、是否使用内固定物、手术时间是否≥120 min、术中失血、术中输血、是否存在脑脊液漏、术后引流管放置时间等14项可能影响因素,将单因素分析筛选出的有意义因素纳入Logistic回归方程进行多因素分析。结果单因素分析显示,术后切口感染感染与是否合并糖尿病、术前预防应用抗生素、是否使用内固定物、手术时间是否≥120 min相关(P<0.05,P<0.01);而与性别、年龄、BMI、血清总蛋白、血清白蛋白水平及肥胖、吸烟/酗酒、术中失血≥200 ml、术中输血、术后引流时间≥4 d、术前营养状况差等无相关性(P均>0.05)。Logistic回归分析显示,合并糖尿病、术前未预防应用抗生素、未使用内固定物、手术持续时间≥120 min是影响感染的主要危险因素(P<0.05,P<0.01)。结论是否合并糖尿病、术前预防应用抗生素、术中使用内固定物、手术持续时间是影响颈椎后路单开门术后切口感染的主要因素。
Objective To Summarize and analyze the related factors of incision infection after operation of cervical posterior single door and provide the reference for clinical practice. Methods Twenty-six cases of post-operative incision infection of cervical posterior single door from January 2000 to June 2017 were retrospectively studied,and 52 cases without post-operative incision infection were selected as control group according to the ratio of 1 ∶ 2 at the same time. By single factor analysis,the meaningful factors screened from age,sex,body mass index（ BMI）,diabetes mellitus,smoking and drinking history,nutritional status（ serum total protein,serum albumin）,preoperative use of antibiotics,whether to use internal fixation,surgical duration,intraoperative blood loss,intraoperative blood transfusion,whether to have leakage of cerebrospinal fluid,time of tube placement,etc. were analyzed by multi-factor logistic regression analysis. Results Single factor analysis showed that postoperative incision infection was associated with diabetes mellitus,preoperative application of prophylactic antibiotics,internal fixation use and whether the operation time was equal or more than 120 mins（ P〈0. 05,P〈0. 01） and has no significant correlation with gender,age,BMI,serum total protein,serum albumin level and obesity,smoking and drinking,intraoperative blood loss（ equal or more than 200 ml）,intraoperative blood transfusion,postoperative drainage time（ equal or more than 4 days） and poor preoperative nutritional status（ all P〉0. 05）. Logistic regression analysis showed that diabetes mellitus,preoperative antibiotic prophylaxis,internal fixation and operation time（ equal or more than 120 mins） were the main risk factors of post-operative incision infection of cervical posterior single door（ P〈0. 05,P〈0. 01）. Conclusion The main factors of postoperative incision infection of cervical posterior single door are associated with whether there are diabetes,preoperative prophylactic antibiotics use,i
作者
张楠
王国胜
王婧瑶
田发明
刘子洪
刘志奎
ZHANG Nan, WANG Guo-sheng, WANG Jing-yao, TIAN Fa-ming, LIU Zi-hong, LIU Zhi-kui(Kailuan General Hospital, Tangshan, Hebei 063000, Chin)
出处
《中国临床研究》
CAS
2018年第5期637-640,共4页
Chinese Journal of Clinical Research
基金
河北省青年科技课题(20150832)
关键词
颈椎后路
单开门术
感染
抗生素
营养状况
糖尿病
内固定
Cervical posterior
Single open-door operation
Infection
Antibiotics
Nutritional status
Diabetes
Internal fixation
