胫骨平台骨折患者切开复位内固定术后切口感染发生率及危险因素分析

Incidence and Risk Factors of Incision Infection after Open Reduction and Internal Fixation in Patients with Tibial Plateau Fracture

目的:分析胫骨平台骨折患者开展切开复位内固定治疗后切口感染发生情况及相关危险因素,为减少切口感染的发生提供临床参考依据。方法:通过便利抽样法,选取南京医科大学附属逸夫医院2018年1月-2021年12月收治的70例胫骨平台骨折患者为研究对象,所有患者均行切开复位内固定治疗,根据患者术后有无感染分为感染组(n=17)和未感染组(n=53),通过单因素及多因素Logistic回归分析法分析影响切口感染的因素。结果:单因素分析结果显示,BMI、吸烟史、骨折类型、术前ASA评分、术前应用抗生素、术前白蛋白水平、糖尿病、手术用时、住院时间是胫骨平台骨折切开复位内固定术患者术后切口感染发生的影响因素(P<0.05)。多因素Logistic回归分析,结果显示,BMI、开放型骨折、手术用时>150 min、术前白蛋白水平<35 g/L及术前ASA评分≥3分是胫骨平台骨折切开复位内固定术患者术后切口感染发生的独立危险因素(P<0.05)。结论:胫骨平台骨折患者切开复位内固定术后切口感染的影响因素较多,术前评估BMI、开放型骨折等风险因素,对降低术后切口感染的发生风险具有重要意义。

Objective:To analyze the incidence of incision infection and related risk factors in patients with tibial plateau fracture after open reduction and internal fixation,so as to provide clinical reference for reducing the incidence of incision infection.Method:Through the convenient sampling method,70 patients with tibial plateau fractures admitted to Yifu Hospital Affiliated to Nanjing Medical University from January 2018 to December 2021 were selected as the study subjects,all patients were treated with open reduction and internal fixation,according to whether the patients had postoperative infection,they were divided into infection group(n=17)and non infection group(n=53).The factors affecting incision infection were analyzed by univariate and multivariate Logistic regression analysis.Result:The results of univariate analysis showed that BMI,smoking history,fracture type,preoperative ASA score,preoperative antibiotics,preoperative albumin level,diabetes,operation time and hospital stay were the influencing factors of postoperative incision infection in patients with open reduction and internal fixation of tibial plateau fracture(P<0.05).Multivariate Logistic regression analysis showed that BMI,open fracture,operation time>150 min,preoperative albumin level<35 g/L and preoperative ASA score≥3 points were independent risk factors for postoperative incision infection in patients with open reduction and internal fixation of tibial plateau fracture(P<0.05).Conclusion:There are many influential factors of incision infection after open reduction and internal fixation in patients with tibial plateau fracture.Preoperative assessment of BMI,open fracture and other risk factors is of great significance to reduce the risk of incision infection after operation.