摘要
目的分析腰椎后路融合内固定术后感染的相关影响因素。方法将腰椎后路融合内固定的46例术后切口感染者作为感染组,138例切口未感染者作为非感染组。分析两组临床资料,对影响术后感染因素进行单因素和多因素logistic回归分析。结果感染者术后5~30 d出现感染症状,感染组30例为革兰阳性菌感染,12例为革兰阴性菌,4例为混合菌。合并糖尿病、术前总蛋白、术前血红蛋白、术前白蛋白、融合节段数、手术时间、术中出血量、手术方式、放置引流管时间、术后引流量、术后血红蛋白、术后白蛋白、术后总蛋白、术后白细胞计数、术后红细胞计数两组比较差异均有统计学意义(P<0.05)。合并糖尿病、融合节段数多、术后出血量多、放置引流管时间长、术后血红蛋白及术后白蛋白降低是腰椎后路融合内固定术感染的独立危险因素。结论合并糖尿病、融合节段数多、放置引流管时间长、术后血红蛋白及术后白蛋白降低是腰椎后路融合内固定术感染的独立危险因素。
Objective To analyze the related influencing factors of postoperative infection of posterior lumbar fusion internal fixation.Methods The 46 patients with incision infection after posterior lumbar fusion and internal fixation were regarded as the infected group,while 138 non-infected patients were regarded as the non-infected group.The clinical data of the two groups patients were analyzed.Single-factor and multi-factor logistic regression analysis were used for the factors affecting postoperative infection.Results Infected patients had infection symptoms at 5~30 d after surgery.In the infection group,30 cases had gram-positive bacteria,12 cases were gram-negative bacteria,and 4 cases were mixed bacteria.Combined with diabetes,preoperative total protein,preoperative hemoglobin,preoperative albumin,number of fusion segments,operative time,intraoperative blood loss,surgical method,drainage tube placement time,postoperative drainage volume,postoperative hemoglobin,postoperative albumin and the total protein,the count of red blood cell and white blood cell had significant difference(P<0.05).Diabetes,a large number of fusion segments,a large volume of postoperative bleeding,long drainage tube placement,postoperative hemoglobin volume and postoperative albumin volume reduction were all independent risk factors for infection after posterior lumbar fusion and internal fixation.Conclusions The combination of diabetes,the number of surgical procedures,the long time of drainage tube,the volume of hemoglobin after surgery and the decrease of postoperative albumin are all independent risk factors of infection after posterior lumbar fusion combined with internal fixation.
作者
刘斌
甘维
王华富
金掌
LIU Bin;GAN Wei;WANG Hua-fu;JIN Zhang(Dept of Spine Surgery,the People′s Hospital of Lishui City,the Sixth Affiliated Hospital of Wenzhou Medical University,Lishui,Zhejiang 323000,China)
出处
《临床骨科杂志》
2020年第6期788-791,共4页
Journal of Clinical Orthopaedics
基金
浙江省丽水市科技局科技计划项目(编号:2017GYX16)
浙江省丽水市高层次人才培养资助项目(编号:2018RC08)
浙江省丽水市科技局公益技术应用研究项目(编号:2017C37158)
浙江省丽水市人民医院人才搭梯工程项目(编号:2017TC006)。
