四肢骨折内固定术后手术部位感染的微生物特征及危险因素分析

The analysis of the microbial characteristics and risk factors of Surgical site infection afier internal fixation of limb fractures

目的 研究四肢骨折内固定术后手术部位感染(SSI)的微生物特征和危险因素.方法 回顾性分析2010年1月至2020年1月在本院接受切开复位内固定治疗的四肢骨折患者.统计学方法采用单因素分析和二元Logistic回归分析.结果 共有4,479例四肢骨折患者被纳入研究,187例患者发生SSI.金黄色葡萄球菌是最常见的病原微生物(占25.1%),其次是凝固酶阴性的葡萄球菌(占18.8%).病原微生物在不同骨折部位的分布没有显著差异.二元Logistic回归分析显示,在发生SSI的患者中,白细胞计数高(OR=2.761)和总蛋白低(OR=3.215)是革兰氏染色阴性菌感染的独立危险因素(P<0.05).近期吸烟(OR=2.367)、开放性骨折(OR=8.497)、低红细胞计数(OR=2.563)和股骨(OR=12.098)、胫腓骨(OR=4.9392)骨折,是SSI发生的独立危险因素(P<0.05).结论 近期吸烟、开放性骨折、低红细胞计数和股骨、胫腓骨骨折是发生SSI的独立危险因素.临床应采取相应措施进行预防,以降低SSI发生的风险.

Objective To investigatethe microbial characteristics and risk factors of Surgical site infetion(SSI)fer interal fixation of limb factures.Methods A retrospective analysis was perfomed on patients with limb fractures who received open reduction and intermal fixation in Zhejang Provincial People's Hospital from January 2010 to January 2020.The statistical methods were univariate analysis and binary Logistic regression analysis.Results A total of 4,479 patients with limb fractures were enrlled,and 187 patients developed SSI.Staphylococus aureus(25.1%)was the most common pathogenic microorganism,fllowed by coagulase negative staphylococcus(18.8%),Binary Logistic regresion analysis showed high white blood cllcount(OR=2.761)and low total protein(OR=3.215) in SS patients was an independent rsk faetor of gram-negative bacteria infection(P<0.05).Recent smoking(OR=2.367),open fracture(OR=8.497),low red blood cellcount(OR=2.563)and the fracture occurred in femur(OR=12.098)and tibiofibular(OR=4.939)were independent risk factors for SSI(P<0.05).ConclusionClinical measures should be taken to prevent the risk factors to reduce the rsk of SSI.