切开复位内固定治疗踝关节骨折术后感染的相关因素分析及检测

Relevant Factors of Infection after Open Reduction and Internal Fixation for Ankle Fracture

目的:探讨影响切开复位内固定治疗踝关节骨折术后感染的相关因素。方法:选取2015年3月至2018年7月本院就诊的238例踝关节骨折患者为研究对象,观察患者治疗前后VAS评分变化情况,对患者进行为期6个月的随访,观察患者治疗后感染发生情况。采用单因素及多因素Logistic回归分析影响踝关节骨折患者术后感染的相关因素,采用受试者工作特征曲线分析联合检测踝关节患者术后感染的价值。结果:踝关节骨折患者治疗后VAS评分明显降低(P<0.05),238例患者中11例(4.62%)发生手术部位感染。单因素及多因素Logistic回归分析显示,年龄、BMI、吸烟、损伤类型、切口清洁程度、手术时间、NEUT及ALB与踝关节骨折患者术后手术部位感染密切相关。联合检测诊断术后手术部位感染的AUC为0.916.结论:切开复位内固定治疗踝关节骨折术后感染与高龄、高BMI、吸烟、手术时间长、切口清洁度差、高NEUT及ALB等相关,此类患者应警惕手术部位感染的发生。

Objective:To explore the related factors of infection after open reduction and internal fixation for ankle fracture.Methods:238 patients with ankle fracture were selected from March 2015 to July 2018.The VAS score was observed before and after treatment.Patients were followed up for six months to observe the incidence of infection after treatment.Univariate and multivariate logistic regression analysis was used to analyze the related factors affecting postoperative infection in patients with ankle fracture.Value of combined detection of post-operative infection in ankle patients was analyzed by receiver operating characteristic curve(ROC)analysis.Results: After treatment,the VAS score of ankle fracture patients decreased significantly(P<0.05).Of 238 patients,11(4.62%) had surgical site infection.Univariate and multivariate logistic regression analysis showed that age,BMI,smoke,injury type,incision cleanliness,operation time,NEUT,ALB were closely related to the infection of surgical site in patients with ankle fracture after treatment.AUC of combined detection for diagnosis of surgical site infection after operation was 0.916.Conclusion:Postoperative infection after open reduction and internal fixation for ankle fracture is associated with age,high BMI,smoking,long operation time,poor incision cleanliness and high NEUT,ALB,etc.Such patients should be alert to the occurrence of surgical site infection.