胸腰椎骨折后路内固定术后感染的危险因素

Risk factors of posterior internal fixation infection for thoracolumbar fractures

目的探讨胸腰椎骨折后路内固定术后感染的相关危险因素。方法分析2019年1月—2020年12月在医院行胸腰椎骨折后路内固定术治疗的225例胸腰椎骨折患者临床资料,其中术后发生感染20例设为病例组,术后未发生感染205例设为对照组。分析胸腰椎骨折后路内固定术后发生感染的相关危险因素,并探究相应的干预措施。结果单因素分析显示,体质量指数(BMI)、吸烟史、合并糖尿病、手术节段数、手术时间、术中异体输血、切口长度是胸腰椎骨折后路内固定术后发生感染的相关因素(P<0.05);多因素Logistic回归分析显示,BMI≥24、吸烟史、合并糖尿病、术中异体输血、手术时间≥3 h、切口长度≥10 cm是胸腰椎骨折后路内固定术后发生感染的独立危险因素(P<0.05)。结论胸腰椎骨折后路内固定术后发生感染与BMI、吸烟史、合并糖尿病、手术时间、术中异体输血、切口长度密切相关,针对各危险因素制订相应的预防措施干预,一定程度上可降低术后感染率。

Objective To explore the related risk factors of posterior internal fi xation infection for thoracolumbar fractures.Methods To analyze the clinical data of 225 patients with thoracolumbar fractures treated with posterior internal fi xation of thoracolumbar fractures in the hospital from January 2019 to December 2020.Among them,20 cases of postoperative infection were set as a case group,and 205 cases without infection after operation were set as a control group.We analyzed the related risk factors of posterior internal fi xation infection of thoracolumbar fractures,and explored the corresponding intervention measures.Results Univariate analysis showed that the body mass index(BMI),smoking history,diabetes mellitus,number of operative segments,operative time,intraoperative allogeneic blood transfusion,and incision length were the related factors for posterior internal fi xation infection of thoracolumbar fractures(P<0.05).Multivariate Logistic regression analysis showed that the BMI≥24,smoking history,diabetes mellitus,intraoperative allogeneic blood transfusion,operative time≥3 h,and incision length≥10 cm were the independent risk factors for posterior internal fixation infection of thoracolumbar fractures(P<0.05).Conclusion The posterior internal fixation infection for thoracolumbar fractures was closely related to BMI,smoking history,diabetes mellitus,operative time,intraoperative allogeneic blood transfusion,and incision length.The corresponding preventive interventions for each risk factor can reduce the postoperative infection rate to a certain extent.