胸腰椎后路内固定术后早期手术部位感染的危险因素分析

Risk Factors for Early Postoperative Surgical Site Infection following Posterior Thoracolumbar Spine Internal Fixation Surgery

【目的】探讨胸腰椎后路内固定术后早期手术部位感染发生的危险因素。【方法】回顾性分析我院2006年7月至2012年7月间共297例胸腰椎后路内固定手术患者的临床资料,分为感染组与未感染组,单因素分析对比两组患者在危险因素方面的差异性,并进行Logistic多因素回归分析。【结果】本组297例患者中8例发生手术部位感染,感染率为2.69%。感染组与未感染组单因素分析发现术前白蛋白浓度、手术时间、糖尿病、术前放疗及使用异体骨等5个指标的差异有统计学意义;多因素回归分析显示,导致手术部位感染的独立危险因素包括术前白蛋白浓度(OR=2.014,P=0.031)、手术时间(OR=1.650,P=0.042)、糖尿病(OR=4.457,P=0.018)和术前放疗(OR=17.338,P=0.004)。【结论】术前白蛋白浓度、手术时间、糖尿病和术前放疗是胸腰椎后路内固定术后早期手术部位感染发生的独立危险因素。

[Objective] To evaluate the risk factors for early postoperative surgical site infection following posterior thoracolumbar spine internal fixation operations.[Methods] A Total of 297 patients with posterior thoracolumbar spine internal fixations were retrospectively reviewed from July 2006 to July 2012.Risk factors for surgical site infection were analyzed using univariate analyses and multivariate logistic regression.[Results] The overall rate of surgical site infection was 2.69% （8/297）.Univariate analyses indicated significant differences in preoperative serum albumin level,the duration of surgery,diabetes,preoperative irradiation and allograft.Independent risk factors identified by multivariate analysis were preoperative serum albumin level （OR =2.014,P =0.031）,the duration of surgery （OR =1.650,P=0.042）,diabetes （OR =4.457,P=0.018） and preoperative irradiation （OR =17.338,P =0.004）.[Conclusion] Preoperative serum albumin level,the duration of surgery,diabetes and preoperative irradiation are the independent risk factors for early postoperative surgical site infection following posterior thoracolumbar spine internal fixation operations.