脊柱手术病人术后切口感染相关危险因素分析

摘要

Objective To investigate related risk factors of incision infection in spinal surgical patients. Methods Between June 2012 and August 2015, a total of 793 patients treated with spinal surgery in our hospital were reviewed retrospectively. The relevant factors such as gender, age, body mass index (BMI), history of diabetes, history of cardiovascular disease, residual cavity and internal fixation influencing the postoperative infection were analyzed by univariate analysis. The factors having significant difference were analyzed by the multivariate Logistic regression analysis. Results In 793 spinal surgical patients, there were 18 patients with incision bacterial infection with the infection rate being 2.27%. The patients with incision infection were older, and had the longer operative time and hospital stay than in those without incision infection with the differences being significant statistically (t=6.38, t=2.75, t=6.35; t<0.05 for all). Univariate analysis revealed that age (χ2=5.31, P=0.02), history of diabetes (χ2=4.65, P=0.03) and internal fixation (χ2=4.31, P=0.04) were the high risk factors for postoperative wound infection, and the correlation between these factors and postoperative wound infection was confirmed by Logistic regression analysis (OR=2.875, P=0.021; OR=2.609, P=0.031; OR=2.625, P=0.038). Conclusion Age, diabetes and placement of internal fixation could have a certain impact on the postoperative incision infection in spinal surgical patients. These patients should be given a targeted intervention treatment program.%目的 探讨脊柱手术病人术后切口感染的相关危险因素.方法 对2012年6月至2015年8月于我院行脊柱外科手术的793例病人的临床资料进行回顾性分析,对可能影响病人术后切口感染的性别、年龄、身体质量指数(body mass index,BMI)、糖尿病病史、心血管疾病史、残腔以及内固定物植入等相关因素进行单因素分析,并对差异具有统计学意义的因素进行多因素Logistic回归分析.结果 793例脊柱手术病人中,切口感染病人18例(迟发2例),感染率为2.27%.与术后切口未感染病人相比,术后切口感染病人年龄明显偏大,手术时间和住院时间均明显延长,差异均具有统计学意义(t值分别为6.38、2.75、6.35;P均<0.05).单因素分析结果显示年龄(χ2=5.31,P=0.02)、糖尿病病史(χ2=4.65,P=0.03)和内固定物植入(χ2=4.31,P=0.04)为术后切口感染的高危因素,进而通过Logistic回归分析证实了以上因素与术后切口感染的相关性(OR=2.875,P=0.021;OR=2.609,P=0.031;OR=2.625,P=0.038).结论 年龄、糖尿病病史和内固定物植入对脊柱手术病人术后切口感染具有一定的影响,对于这些病人应给予具有针对性的干预治疗方案.