脊柱内固定术后手术部位感染危险因素调查分析

Risk factors of surgical site infection following spinal internal fixation surgery

目的调查并分析脊柱内固定术后手术部位感染(SSI)的危险因素。方法对该院骨科2015-04~2016-06接受脊柱内固定手术患者405例的临床资料进行回顾性调查,分析其SSI的发生率及其影响因素。结果 405例患者中,有11例(2.72%)发生SSI;单因素分析显示年龄、性别、手术风险分级标准评分(NNIS)、手术持续时间、术中失血量、输血及脑脊液漏与SSI有关,多因素Logistic回归分析显示年龄>60岁(OR=4.10,95%CI=1.01~16.75)、手术持续时间>4 h(OR=5.20,95%CI=1.29~21.03)、有脑脊液漏(OR=7.89,95%CI=1.09~56.89)是脊柱内固定术后发生SSI的独立危险因素。结论脊柱内固定术后院内手术部位感染与多种因素相关,应针对相关危险因素采取积极的预防和控制措施,减少SSI的发生。

Objective To investigate the risk factors of surgical site infection（ SSI） following spinal internal fixation surgery. Methods From April 2015 to June 2016,the retrospective survey was conducted for the patients who underwent spinal internal fixation operation in the department of orthopaedics,and the incidence and risk factors of SSI were analyzed. Results The incidence of SSI was 2. 72%（ 11/405）. Univariate analysis showed that age,gender,NNIS,the operation duration,intraoperative blood loss,transfusion and cerebrospinal fluid leakage were related to SSI. The multiple logistic regression analysis showed that age（ 60 years）（ OR = 4. 10,95% CI = 1. 01 ~16. 75）,the operation duration（ 4 h）（ OR = 5. 20,95% CI = 1. 29 ~ 21. 03） and cerebrospinal fluid leakage were the independent risk factors of SSI. Conclusion Occurrence of the surgical site infection following spinal internal fixation surgery is related to multiple factors,and therefore the corresponding prevention and control contermeasures should be taken to reduce the incidence of SSI.