胸腰段骨折内固定术后并发感染的危险因素分析

Risk factors for infections after thoracolumbar fracture fixation

目的分析胸腰段骨折内固定术后并发感染的危险因素,以期提高临床治疗水平。方法选择2011年1月-2013年2月在医院行内固定术治疗的125例胸腰段骨折患者,观察术后感染发生情况,对其影响因素进行分析,并给予相应的处理措施,伤口换药频率为每天2～3次;采用SPSS16.0统计软件对数据进行处理。结果 125例胸腰段骨折患者手术后有7例发生感染,感染率5.6%,其中3例患者术前患有糖尿病、2例患有冠心病、1例患有脑血管疾病;术后感染的发生与患者的年龄、基础疾病、手术持续时间等因素有关,且患者年龄、基础疾病以及手术持续时间是影响胸腰段骨折内固定术后并发感染的独立危险因素;使用敏感抗菌药物对患者进行治疗两周后痊愈,未出现脊柱骨质改变与神经症状加重现象。结论胸腰段骨折内固定术后患者可存在一定的感染风险,与手术后急性感染相比,应加强对迟发性感染的早期诊断与识别,患者年龄较大、手术时间较长,同时患有糖尿病、高血压以及心脑血管等疾病是内固定术发生感染的独立危险因素,必须采取有针对性的预防措施。

OBJECTIVE To analyze the risk factors for infections after the thoracolumbar fracture fixation so as to improve the level of clinical treatment. METHODS A total of 125 patients with thoracolumbar fracture who under- went the internal fixation in the hospital from Jan 2011 to Feb 2013 were enrolled in the study, then the incidence of postoperative infections was observed, the risk factors were analyzed, the corresponding coping measures were carried out, the frequency of drug dressing for wound was 2 to 3 times everyday, and the statistical analysis of da- ta was performed with the rise of SPSS 16.0 software. RESULTS Of the 1E5 patients with thoracolumbar fracture, the postoperative infections occurred in 7 cases with the infection rate of 5.6%, including 3 cases of preoperative diabetes, 2 cases of coronary heart disease, and 1 case of cerebrovascular disease. The incidence of the postopera- tive infections was associated with the age, underlying disease, or operation duration; the age, underlying disease, and operation duration were the independent risk factors for the postoperative infections in the thoracolumbar frac- ture patients undergoing the internal fixation. The patients were cured after the treatment with susceptible antibi- otics for two weeks, and the change of spinal bone or aggravation of neurological symptoms did not occur. CONCLUSION The patients with thoracolumbar fracture are at certain risk of infections after the internal fixation; as compared with the postoperative acute infections, the early diagnosis and identification of delayed infections should be strengthened. The advanced age, long operation duration, and complication of diabetes, hypertension, or cerebrovascular disease are the independent risk factors for the infections in the patients undergoing the internal fixation, and it is necessary to take targeted prevention measures.