骨科手术切口感染相关危险因素分析

Related risk factors for surgical incision infections in department of orthopedics

目的研究骨科手术切口感染的危险因素与切口感染的关系，以期预防和控制切口感染的发生。方法收集1984例骨科手术患者的临床资料，分析骨科手术切口感染的可能危险因素，并对其进行单因素分析与logistic回归分析。结果1984例患者中发生切口感染56例，切口感染率2．82％；其中≥60、30～60、＜30岁的感染率分别为4．88％、1．88％、1．72％；手术时间≥2、〈2h的感染率分别为3．67％、1．53％；合并基础疾病、无基础疾病患者的感染率分别为4．95％、1．59％；Ⅲ、Ⅱ、Ⅰ类切口的感染率分别为5．16％、2．13％、1．00％；住院时间≥20d＜20d的感染率分别为3．46％、1.69％，两组比较差异均有统计学意义（P＜0．05）；logistic多因素回归分析显示，年龄、合并基础疾病、手术时间和手术切口类型是切口感染发生的独立危险因素。结论骨科手术切口感染的发生率较高，应根据切口感染发生的危险因素采取相应的干预措施，预防和控制切口感染的发生。

OBJECTIVE To explore the risk factors for surgical incision infections in the department of orthopedics so as to prevent and control the incision infections. METHODS The clinical data were collected from 1 984 patients of the orthopedics department, then the risk factors for the surgical incision infections were analyzed, and the univariate analysis and the logistic regression analysis were performed. RESULTS The incision infections occurred in 56 of 1984 patients with the incidence rate of 2.82%. The infection rate was 4.88% in the patients aged no less than 60 years old, 1.88% in the patients aged from 30 and 60 years old, 1.72% in the patients aged less than 30 years old. The infection rate was 3.67% in the patients with the operation duration no less than 2 hours, 1.53% in the patients with the operation duration less than 2 hours; the infection rate was 4.95 % in the patients with complication of underlying disease, 1.59% in the patients without complication of underlying diseases% the infection rate was 5.16% in the patients undergoing type Ⅲ incision surgery, 2.13% in the patients undergoing type Ⅱ incision surgery, 1.00% in the patients undergoing type I incision surgery; the infection rate was 3.46% in the patients with the hospitalization duration no less than 20 days, 1.69 % in the patients with the hospitalization duration less than 20 days, and there were significant differences between the two groups （P〈0. 05）. The multivariate logistic regression analysis indicated that the age, complication of underlying disease, operation duration, and types of surgical incision were the independent risk factors for the incision infections. CONCLUSION The incidence of surgical incision infections is high in the department of orthopedics. It is necessary to take corresponding intervention measures according to the risk factors for the incision infections so as to prevent and control the incision infections.