儿童脊髓栓系松解术患者医院感染危险因素分析

Analysis of risk factors for nosocomial infection in children undergoing tethered cord release surgery

目的 了解行脊髓栓系松解(TCR)术后儿童患者发生医院感染的特点及其危险因素。方法 采取前瞻性调查方法,对某儿童医院神经外科TCR术患者术后感染危险因素进行统计分析。结果 共调查该医院行脊髓手术的患者798例,发生医院感染95例、97例次,感染率为11.90%、例次感染率为12.16%。感染部位以上呼吸道感染为主(26.80%),其次是泌尿道感染(20.62%)和尿管相关性尿路感染(18.56%)。手术部位感染发生率为0.38%,其中1例为深部切口感染,2例为器官腔隙感染。多因素分析结果显示,手术时长、住院总天数、术后抗菌药物使用天数是儿童TCR术后患者发生感染的独立危险因素(P <0.05),年龄增加发生感染的风险降低(OR=0.897,P=0.034)。结论 儿童TCR术后发生感染的危险因素较多,应采取针对性的预防控制措施。

Objective To understand the characteristics and risk factors of nosocomial infection in children after tethered cord release(TCR)surgery.Methods A prospective investigation method was used to statistically analyze the risk factors of postoperative infection in neurosurgery patients undergoing TCR in a children's hospital.Results A total of 798 patients undergoing spinal cord surgery were investigated in this hospital,and 95 cases and 97 case times of nosocomial infection occurred,with an infection rate of 11.90%and a case-time infection rate of 12.16%.The main infection site was the upper respiratory tract infection(26.80%),followed by urinary tract infection(20.62%)and catheter-associated urinary tract infection(18.56%).The incidence of surgical site infection was 0.38%,including 1 case of deep incisional infection and 2 cases of organ lacuna infection.Multivariate analysis showed that the length of operation,total days of hospitalization,and days of postoperative antibiotic use were independent risk factors for infection in children after TCR sugery(P<0.05),and the risk of infection decreased with age increasing(OR=0.897,P=0.034).Conclusion There are many risk factors for infection after TCR surgery in children,and targeted prevention and control measures should be taken.