异体红细胞输注与脊柱手术术后医院感染的相关性

Association research between allogeneic blood transfusion with nosocomial infections after spine surgery

目的探讨异体红细胞输注患者与未输注患者在实施脊柱手术术后医院感染发生率的差异。方法回顾性分析186例接受脊柱手术患者资料,其中输注异体红细胞112例(红细胞输注组),未输注异体红细胞74例(非红细胞输注组)。对两组患者的基本特征、术后医院感染发生率进行比较,并对可能影响患者术后医院感染发生率的因素进行影响因素筛选。结果红细胞输注组术后手术部位感染发生率及总感染发生率较高,与非红细胞输注组比较差异有统计学意义(P<0.05)。尿路感染、肺部感染、败血症等其他感染发生率两组比较差异无统计学意义(P>0.05)。Logistic回归进行影响因素筛选结果显示,红细胞输注、术后引流管放置可能是影响患者感染发生率的重要因素。结论异体红细胞输注可能与患者术后医院感染发生相关,应严格把握其临床适应证。

Objective To compare the infection incidence rate difference of nosocomial infections in patients who did and did not receive allogeneic blood transfusions after spine surgery. Methods One retrospective study was carried out in 186 patients with spine surgeries; there were 112 patients who received allogeneic blood transfusions （red blood cell transfusion group） and 74 patients who did not receive （non-red blood cell transfusion group）. The basic charac- teristics, incidence rates of nosocomial infections between the two groups were compared; variables logistic regression was used for screening the the factors that affected the incidence of nosocomial infections. Results Incidence rates of surgical site incision infections and total infections of patients in the transfusion group were statistically higher than the non-transfusion group （ P 〈 O. 05 ）. Incidence rates of the other infections including urinary tract infections, pul- monary infections, and septicemia in the transfusion group were not statistically higher than the non-transfusion group （P 〉 0. 05 ）. Results of multiple variables logistic regression showed that the factors including the allogeneic blood transfusion and drain usage might be the important factors having effects on the infections incidence in patients with spine surgeries （P 〉 0. 05）. Conclusions Blood transfusion can be associated with the increasing incidence of nos- ocomial infections in patients with spine surgeries, so the indications for transfusion should be controlled stringently.