脊柱手术后患者外科手术部位感染及相关危险因素（英文）

Surgical site infection and related risk factors among patients following spinal surgery

目的外科手术部位感染(SSI)是脊柱手术后常见的并发症之一,与感染发病率增高,治疗时间延长,医疗费用增加,患者预后效果不良有着密不可分的关系。本研究的目的是探索某教学医院患者进行脊柱手术后发生SSI的现状与其相关危险因素。方法采用前瞻性队列研究方法,对2014年6月26日-11月30日该院所有脊柱手术患者进行目标性监测,以美国疾病控制与预防中心(CDC)颁布的指南作为SSI的诊断依据,通过床旁调查与出院后的检查发现SSI病例,使用标准化的数据收集脊柱手术患者术前,术中及术后资料。结果 2014年6月26日—11月30日共监测192例脊柱手术患者,其中7例(3.6%)发生了SSI。通过双变量分析的方法发现切口类型(污染/感染切口)、外科引流、输血与增加SSI风险的密切相关。在192例脊柱手术患者中,120例(62.5%)给予静脉使用预防性抗菌药物,使用周期为2.2(1~9)d,139例(72.4%)使用中成药。结论该研究有助于了解该教学医院脊柱手术后患者SSI发病率,亦为今后进行脊柱手术后患者发生SSI的研究提供有价值的信息。

ObjectiveSurgical site infection （SSI） is associated with morbidity, increased healthcare costs and in some cases poor outcomes in patients. The purpose of this study was to identify the burden of SSI and the risk factors among hospitalized patients undergoing spinal surgery in a Chinese hospital.MethodsA prospective cohort study was performed in patients who underwent spinal surgery in a hospital of traditional Chinese medicine （TCM） in China from June 26 to November 30 in 2014. SSI was diagnosed according to the Centers for Disease Control and Prevention （CDC） criteria of the U.S., and was identified by bedside surveillance and postdischarge follow up. The detailed characteristics of pre, intra and postoperative patients were recorded with a standardized data collection form.ResultsA total of 192 patients with spinal surgery were included in the study, 7（3.6%） of these patients developed SSI. Contaminated and dirty/infected wound, surgical drainage, and blood transfusion were associated with increased Odds of SSI by bivariate analysis. Intravenous antimicrobial prophylaxis （AMP） was given in 120 of 192 （62.5%） spinal surgery. The average duration of AMP administered was 2.2 days （range, 1-9）, 139 （72.4%） of 192 patients were prescribed TCM after spinal surgery.ConclusionThe incidence of SSI among patients after spinal surgery in a hospital of TCM in China was identified. This study is served as a reference for studying SSI in spinal surgery in future, and also provides the valuable information to formulate SSI prevention programs.