摘要
目的探讨成人骨折损伤病人应激性高血糖与发生术后手术部位感染的相关性。方法收集2018年1月-2020年10月苏州大学附属无锡第九人民医院收治的符合纳入和排除标准的327例患者,根据是否发生高血糖(血糖值>140 mg/dL)分为高血糖组(n=120)和非高血糖组(n=207)。从患者病历资料中提取人口学和临床特征,比较两组患者术后手术部位感染发生率,应用多因素Logistic回归分析影响成人骨折损伤术后手术部位发生感染的危险因素。结果高血糖组和非高血糖组患者平均年龄(t=-1.693,P=0.090)、性别构成(χ^(2)=0.836,P=0.361)、有慢性病病史比例(χ^(2)=0.133,P=0.715)、有吸烟史比例(χ^(2)=1.291,P=0.256)、从发病至入院时间(U=0.944,P=0.345)差异均无统计学意义,但两组患者有酗酒史比例(χ^(2)=6.062,P=0.014)和AIS评分(U=8.514,P<0.001)差异均有统计学意义。高血糖组患者手术部位感染发生率显著高于非高血糖组(12.50%vs.5.80%;χ^(2)=4.51,P=0.023)。Logistic回归分析结果显示,入院血糖水平是骨折损伤患者术后发生手术部位感染的危险因素(P=0.023);且患者术后发生手术部位感染风险随血糖值升高而增加,在入院血糖值>200 mg/dL时更显著(OR=4.095,P=0.008)。结论成人骨折损伤后应激性高血糖与手术部位感染显著相关,入院血糖值>200 mg/dL可显著增加术后手术部位感染发生率。应激性高血糖是成人骨折损伤术后发生手术部位感染的危险因素。
Objective To investigate the relationshipbetween stress hyperglycemia andpostoperative surgical site infection in adult patients with fracture injury.Methods The medical records of 327 patients meeting the inclusion and exclusion criteria that wereadmitted to Department of Intensive Care Unit,Wuxi 9 th Hospital Affiliated to Soochow University during the period from January 2018 to October 2020 were reviewed,and all patients were assigned into the hyperglycemia group(n=120)and non-hyperglycemia group(n=207)according to the presence of hyperglycemia(blood glucose>140 mg/dL).The demographic and clinical features were compared between the two groups,and multivariate logistic regression analysis was performed to identify the risk factors of postoperative surgical site infection in adult fracture injury.Results There were no significant differences between the hyperglycemia group and non hyperglycemia group in terms of mean age(50.2410.27 vs.47.5112.33 years;t=-1.693,P=0.090)and gender ratio(124/83 vs.83/42;χ^(2)=0.836,P=0.361),proportion of chronic diseases history(169/38 vs.96/24;χ^(2)=0.133,P=0.014),proportion of smoking history(160/47 vs.86/34;χ^(2)=1.291,P=0.256)and duration from onset to admission(3(2)vs.3(2)h;U=-9.44,P=0.345).However there were significant differencesin the ratio ofalcoholism history of(175/32 vs.88/32;χ^(2)=6.062,P=0.361)and AIS score(2(1)vs.3(2);U=-8.5144,P<0.01).The incidence of surgical site infection in hyperglycemia group was significantly higher than that in non-hyperglycemia group(12.50%vs.5.80%χ^(2)=4.51,P=0.023).Multivariate logistic regression analysis revealed that admission blood glucose level was a risk factor for postoperative surgical site infection in patients with fracture injury(P=0.023).Moreover,the risk of postoperative surgical site infection increased with the increase of blood glucose level,and it was more significant when the admission blood glucose value was>200 mg/dL(P=0.008,OR=4.095,95%CI:1.434-11.693).Conclusion Stress hyperglycemia significantly correlates wit
作者
王燕
韩佳慧
徐策
蔡济民
葛新
WANG Yan;HAN Jia-hui;XU Ce;CAI Ji-min;GE Xin(Department of Intensive Care Unit,Wuxi 9th Hospital Affiliated to Soochow University,Wuxi,Jiangsu 214000,China)
出处
《中国病原生物学杂志》
CSCD
北大核心
2021年第12期1477-1479,1484,共4页
Journal of Pathogen Biology
基金
无锡市卫健委精准医学重点专项(No.J202007)
无锡市卫健委重大科研项目(No.Z202105)。
关键词
应激性高血糖
手术部位感染
骨折损伤
关联研究
stress hyperglycemia
surgical-site infection
fracture injury
correlation study
