摘要
目的回顺分析腰椎后路内固定融合术后深部感染的治疗，探讨其内固定移除的影响因素。方法2008—01-2013-12病区共收治腰椎后路内固定融合术后术区深部感染35例，根据末次随访内固定是否移除分为内固定移除组（13例）和内固定保留组（22例），采用单因素及多因素L乒gistic回归分析内固定移除的影响因素。结果金黄色葡萄球菌及耐甲氧西林金黄色葡萄球菌为腰椎后路内固定融合术后深部感染最常见病原菌，占40％。单因素分析发现迟发型感染、术中异体输血、清创次数≥3次与内固定移除有关（P〈0．05）。多吲素Logistic同归分析显示迟发型感染（OR=17．458，95％CH．639～185．919）、清创次数≥3次（OR=53．154，95％CI=2．591～1090．417）是腰椎后路内固定融合术后深部感染内固定移除最重要的影响因素。结论腰椎后路内固定融合术后深部感染的治疗，对于迟发型感染及清创次数达到3次时应考虑移除内固定，以利于有效的控制感染。
Objective Retrospective analysis of the treatment of postoperative deep infection following Posterior Lumbar Instrumented Arthrodesis and to explore risk factors of implant re- movalfor postoperative deep infection following Posterior Lumbar Instrumented Arthrodesis. Meth- ods From January 2008 to December 2013, a total of 35 patients developed postoperative deep surgical site infection following Posterior Lumbar Instrumented Arthrodesis were treated in our ward. According to the results of final follow-up, 13 patients suffered from implant removal（im- plant removal group） and 22 patients maintained implant retention （implant retention group）. Risk factors for implant removal were determined with univariate analyses and multivariate logis- tic regression. Results Staphylococcus aureus and MRSA was the most common pathogens of postoperative deep infection following Posterior Lumbar Instrumented Arthrodesis,accounting for 40% of all infection. Univariate analyses showed delayed infection,allogeneic blood transfusions, and debridement frequency i〉3 was associated with implant removal. Multivariate analysis showed that delayed infection （0R：17.458,95%CI=1.639-185.919）and debridement frequency i〉 3 （OR=53.154,95%CI=2.591-1090.417） were the strongest risk factors of implant removal for postoperative deep infection following Posterior Lumbar Instrumented Arthrodesis. Conclusion For the treatment of postoperative deep infection following Posterior Lumbar Instrumented Arthrodesis,implant removal should be considered in order to clear infection when delayed infec-tion occurred and debridement frequency reaches three times.
出处
《颈腰痛杂志》
2016年第3期165-170,共6页
The Journal of Cervicodynia and Lumbodynia
基金
国家自然科学基金(编号:81171754)
上海市科委重点项目(11JC1416301)
关键词
腰椎后路内固定融合术
术区深部感染内固定移除
因素分析
posterior lumbar instrumented arthrodesis
deep surgical site infection
implant re-moval
risk factors
