腰椎管狭窄症椎弓根内固定术后深部感染的因素分析及处理措施

摘要

Objective:To explore the related factors of deep infection of lumbar spinal stenosis after ped-icle screw fixation and treatment measures. Methods:1244 cases of patients treated with pedicle screw fixation due to umbar spinal stenosis in our hospital from April 2011 to April 2016 were selected as the study objects. Single factor and multiple Logistic regression analysis were applied to analyze the related factors of deep infec-tion of lumbar spinal stenosis after pedicle screw fixation. Results:In the study,11 cases of patients with deep infection from 1244 cases of patients were detected, and 19 strains of pathogens were isolated. Of them, 9strains were gram positive bacteria (47.37%), 10 strains were gram negative bacteria (52.63%), in which staphylococcus aureus accounted for the highest proportion ( 44. 44%) . There were on relations between pa-tients' gender, antibiotic use time and the incidence of deep infection ( P > 0. 05 ) . Single factor analysis showed factors like age more than 65,operation time more than 100 min,intraoperative blood loss more than 500ml, basic diseases or not,postoperative drainage time less than 2d,and BMI>30 kg/m2 were closely re-lated to the incidence of deep infection ( P< 0.05) . Multiple Logistic regression analysis showed independent risk factors were age,operation time,bleeding volume and BMI to induce deep infection ( P<0.05) . Conclu-sion:There are many factors inducing deep infection,and the hospital should do well in perioperative nursing care in order to prevent deep infection.%目的:探讨腰椎管狭窄症椎弓根内固定术后深部感染的相关因素以及处理方法.方法:选取2011年4月至2016年4月因腰椎管狭窄症采用椎弓根内固定术进行治疗1244例患者作为研究对象,采用单因素和多元Logistic回归分析法分析了腰椎管狭窄症椎弓根内固定术后深部感染的相关因素,并提出处理性措施.结果:本研究1244例患者中发生深度感染的有11例,检出病原菌19株,革兰阳性菌9株(占47.37%),革兰阴性菌10株(占52.63%),其中金黄色葡萄菌所占比例最高,为44.44%;患者性别、抗生素使用时间与深度感染的发生率无关(P>0.05);患者年龄>65岁、手术时间>100min、术中出血量>500mL、存在基础性疾病、术后引流时间<2d、BMI>30kg/m2与深度感染的发生率关系密切(P<0.05);经Logistic非条件性多因素分析,患者年龄、手术时间、术中出血量、BMI均是诱发深度感染的独立危险因素(P<0.05).结论:诱发深部感染的因素较多,医院要做好围手术期相关治疗护理工作,预防深部感染发生.