骨科手术部位感染危险因素分析

Analysis on risk factors of surgical site infection in orthopedic patients

目的研究骨科手术部位感染(SSI)的危险因素,为防控SSI提供依据。方法通过回顾性分析方法,对某医院住院实施骨科手术的患者发生手术部位感染情况及其危险因素进行研究与分析。结果该医院连续4年共实施骨科手术23 760例,发生SSI共计182例,SSI发生率为0.77%。从SSI患者送检标本中共检出病原菌90株,主要为金黄色葡萄球菌、表皮葡萄球菌和大肠埃希菌。清创术患者SSI发病率最高,其次为关节置换术。多因素分析结果显示,住院时间超过14 d,术前住院时间超过7 d,Ⅱ、Ⅲ类切口等因素为骨科手术患者SSI的独立危险因素。结论骨科手术部位感染的相关因素较多,应及时采取针对性的措施进一步控制手术部位感染的发生。

Objective To investigate the risk facotors of surgical site infection（ SSI） in patients undergoing orthopedic surgery,and provide methods and basis for prevention and control of SSI. Methods Retrospective investigation was used to analyze the incidence of SSI and risk factors of information of all the hospitalized orthopedic patients undergoing surgery in a hospital. Results There were 23 760 cases of orthopedic patients undergoing surgery,182 cases had SSI,the incidence rate was0. 77%. 90 strains of pathogenic bacteria were isolated,mainly were Staphylococcus aureus,Staphylococcus epidermidis,and Escherichia coli. The incident rate of SSI in patients with debridement was the highest,followed by patients with arthroplasty.Multivariate logistic regression analysis indicated that length of hospital stay（ 〉14 d）,length of preoperative hospital stay（ 〉7 d）,surgical incision classification（ typeⅡincision; type Ⅲ incision） were independent risk factors for SSI in patients undergoing orthopedic surgery. Conclusion There are many risk factors for SSI in patients undergoing orthopedic surgery,and targeted measures should be taken in time to further control the occurrence of surgical site infections.