关节镜下肩袖修补术后感染的危险因素分析

Risk factors for infections after arthroscopic rotator cuff repair

目的:探讨关节镜下肩袖修补术后感染的危险因素,为降低感染发生提供依据。方法:对2019年1月至2022年1月采用关节镜下肩袖修补治疗的2591例肩关节镜下肩袖修补术后患者的临床资料进行回顾性分析,其中男1265例,女1326例;年龄25~82(51.5±15.6)岁。按照术后是否发生感染分为感染组(n=18)和未感染组(n=2573),记录两组患者性别、年龄、是否吸烟、有无糖尿病、身体质量指数、术前1个月内是否进行局部封闭、手术时间、是否预防性使用抗生素、是否有内固定置入等,应用单因素Logistic回归分析筛选出术后感染的危险因素,再将有统计学意义的危险因素纳入多因素Logistic回归分析,筛选出关节镜下肩袖修补术后感染的独立危险因素。结果:本组2591例患者中,术后发生感染18例,感染率为0.69%,单因素分析结果显示性别、年龄、手术时间、预防性使用抗生素、内固定置入是关节镜下肩袖修补术后患者发生感染的危险因素。多因素Logistic分析显示男性(OR=14.227)、年龄≥65岁(OR=34.313)、手术时间≥2h(OR=15.616)、未预防性使用抗生素(OR=4.891)以及有内固定置入(OR=5.103)是关节镜下肩袖修补术后感染的独立危险因素(P<0.05)。结论:男性、年龄≥65岁、手术时间≥2 h、未预防性使用抗生素以及有内固定置入是关节镜下肩袖修补术后感染的独立危险因素,临床应早期诊断和及时处理,降低感染发生率。

Objective To explore risk factors for infections after arthroscopic rotator cuff repair,and improve the under standing for reducing infection.Methods Clinical data of 2591 patients who underwent arthroscopic rotator cuff repair from January 2019 to January 2022 were retrospectively analyzed,including 1265 males and 1326 females,aged from 25 to 82 years old with an average age of(51.5±15.6)years old.They were divided into infection group(n=18)and uninfected group(n=2573)according to whether or not patients had postoperative infection.Gender,age,smoking,diabetes,body mass index,local closure within 1 month before operation,operation time,preventive use of antibiotics,and internal fixation implantation between two groups were recorded.Univariate Logistic regression analysis screened factors associated with infections after arthroscopic rotator cuff repair.The results were entered into the multivariate logistic regression analysis,screening the high risk factors for infections after arthroscopic rotator cuff repair.Results In 2591 patients,18 patients were infected after operation,infection rate was 0.69%.Univariate Logistic regression analysis showed that gender,age,operation time,antibiotic prophylaxis,internal fixation implantation were risk factors for infections after arthroscopic rotator cuff repair.Multivariate Logistic regression analysis showed male(OR=14.227),age≥65 years(OR=34.313),operation time≥2 h(OR=15.616),without antibiotic prophylaxis(OR=4.891),and internal fixation implantation(OR=5.103)were major risk factors for infection after arthroscopic rotator cuff repair(P<0.05).Conclusion Male,age≥65 years,operation time≥2 h,without antibiotic prophylaxis and internal fixation implantation were independent risk factors for infection after arthroscopic rotator cuff repair.Early diagnosis and timely treatment should be carried out to reduce the incidence of infection.