骶骨肿瘤切除术后切口感染影响因素的logistic回归分析

Analysis of influencing factors for postoperative wound infections of sacral tumors after surgical resection

目的：分析骶骨肿瘤切除术后切口感染的影响因素。方法：回顾性分析经手术治疗的128例骶骨肿瘤患者基本资料、术后切口感染情况以及术前、术中和术后不同处理方式对切口感染的影响。结果：128例骶骨肿瘤患者中有21例（16.4%）出现术后切口感染。手术次数、放疗史、手术时间、放置内固定、缝合前手术视野行双氧水冲洗、切口距肛门距离和围手术期行胃肠道准备是骶骨肿瘤切除术后切口感染的影响因素（χ2=9.969、12.764、10.557、10.819、19.574、14.131、25.718,P〈0.05）。多因素logistic回归分析结果显示放疗史和放置内固定是切口感染的危险因素（OR=2.376和1.461,95%CI=1.213~2.869和1.044~2.805）,缝合前手术视野行双氧水冲洗和围手术期行胃肠道准备是其保护因素（OR=0.772和0.731,95%CI=0.512~0.895和0.498~0.836）。结论：骶骨肿瘤切除术围手术期放置内固定要有严格的适应证。缝合前手术视野应行双氧水冲洗,围手术期应行胃肠道准备。

Aim：To explore the influencing factors for postoperative wound infections of sacral tumors after surgical re -section.Methods：A retrospective analysis was done and the general information of the patients , wound infections and pre-operative, intraoperative and postoperative factors were collected from 128 patients with sacral tumors who underwent surgi-cal excision.Results：A total of 21 cases（16.4%） acquired postoperative wound infection .Surgery times, previous radia-tion, operating time, instrumentation, rinsing surgical field using hydrogen peroxide before suture , the distance from wound to anus and perioperative preparation of gastrointestinal tract were influencing factors of postoperative wound infections （χ2 =9.969,12.764,10.557,10.819,19.574,14.131,25.718,P〈0.05）.Previous radiation and instrumentation were risk factors for postoperative infections （OR were 2.376 and 1.461,95%CI were 1.213-2.869 and 1.044-2.805）;Rinsing surgical field using hydrogen peroxide before suture and perioperative preparation of gastrointestinal tract were protection factors for postoperative infections（OR were 0.772 and 0.731,95%CI were 0.512-0.895 and 0.498-0.836）.Conclu-sion：Instrumentation as a risk factors for postoperative wound infections of sacral tumors after surgical resection should be avoided and the protection factors such as rinsing surgical field using hydrogen peroxide before suture and perioperativepreparation of gastrointestinal tract should be used during surgical excision of sacral tumors.