腰椎管狭窄症术后手术部位感染危险因素分析

Related Risk Factors for Surgical Site Infections of Lumbar Spinal Stenosis

目的分析腰椎管狭窄症术后手术部位感染的危险因素,为预防该类手术部位感染提供依据。方法回顾2006年1月～2011年12月在北京市某三级甲等综合医院骨科住院接受手术治疗腰椎管狭窄症的病例。将术后发生手术部位感染的患者为病例组(38例),同随机抽取未发生手术部位感染的患者对照组(70例)进行病例对照研究。结果单因素分析发现,肥胖(P=0.040)、手术中出血量大(P=0.050)、术后引流天数多于4天(P=0.032)是发生术后感染的危险因素;多因素分析发现,术后引流天数多于4天(P=0.006)是发生术后感染的危险因素。术后预防性使用抗生素持续时间长短与发生手术部位感染(P=0.394)没有明显关联。结论肥胖、手术中出血量大、术后引流天数多于4天是腰椎管狭窄手术术后出现手术部位感染的危险因素。术后预防性使用抗生素与手术部位感染没有明显关联。术前应向肥胖患者解释高危因素的存在;术中应进行细致的手术操作,减少出血;术后加强引流管护理并及时拔除。没有必要延长术后使用抗菌药物的时间。

Objective To analyze the risk factors of surgical site infections in the lumbar spinal stenosis,to provide the scientific bases for clinical reasonable methods of controlling hospital infection.Methods Select the cases from the patients who received lumbar position surgery and put them into two groups.In this study,the case group include 38 patients who suffered from SS1 after lumbar position operation,and was compared with a control group including 70 cases. Try to find the difference of the parameters in the preoperative period.Results There are statistics differences in the factors of obesity （P=0.040） ,intraoperative amount of bleeding （g--0.050） and postoperative drainage days （P=0.032） in single factor analysis. There is onlg one factor has statistics difference in logistic regression：postoperative drainage days （P=0.006） .There is no statistics difihrence in Postoperative antibiotic usage time.Conc I us ions It is benefit for the patients to prevent surgical site infections： to adjust patients into steady state;to finish the operation skillfully and reduce the amount of bleeding,to protect the drainages carefully and remove it timely,to use the antibiotics correctly.