摘要
目的探讨胸腰椎骨折老年患者术后感染的病原学特点,分析其影响因素与对策。方法256例胸腰椎骨折手术患者,根据是否感染分为感染组和非感染组,分析术后感染患者的病原菌,比较是否感染患者间的临床资料差异,采用Logistic回归分析高龄胸腰椎骨折患者术后感染的影响因素。结果256例胸腰椎骨折老年患者术后发生感染7例,感染率为2.73%,包括表浅手术感染5例、深部手术感染2例,早期感染4例、迟发感染3例。7例感染患者共分离出病原菌16株,其中革兰氏阳性菌11株、革兰氏阴性菌4株、假丝酵母菌1株,占比分别为68.75%、25.00%和6.25%。Logistic回归分析显示,年龄76~90岁、开放性骨折、非层级手术室、术前30 min未使用抗菌药物、手术时间≥3 h、慢性呼吸道疾病合并症是引发患者术后感染性疾病的危险因素(OR=4.760、5.580、6.360、7.030、5.990、5.050,均P<0.05)。结论老年胸腰椎骨折患者术后存在一定感染风险,以革兰氏阳性菌感染为主,临床应针对危险因素采取措施预防感染。
Objective To explore the pathogenic characteristics of postoperative infection in elderly patients with thoracolumbar fracture,and to analyze its influencing factors and countermeasures.Methods A total of 256 patients undergoing thoracolumbar fracture surgery were divided into the infection group and the non-infection group.The postoperative pathogens were analyzed,and the clinical data among the two groups were compared.Logistic regression was used to analyze the influencing factors of postoperative infection in elderly patients with thoracolumbar fracture.Results Seven cases of 256 elderly patients with thoracolumbar fracture developed postoperative infection,with an infection rate of 2.73%,including five cases of superficial surgical infection,two cases of deep surgical infection,four cases of early infection,and three cases of delayed infection.A total of 16 strains of pathogen were isolated from seven infected patients,including 11 strains of Gram-positive bacteria,four strains of Gram-negative bacteria,and one strains of Candida,accounting for 68.75%,25.00%,and 6.25%,respectively.Logistic regression analysis showed that the age 76-90 years old,open fracture,non hierarchical operating room,no antibiotics used 30 minutes before surgery,operation time≥3 h,combined with chronic respiratory disease were risk factors for postoperative infection in patients with thoracolumbar fracture(OR=4.760,5.580,6.360,7.030,5.990,5.050;P<0.05).Conclusions There is a certain infection rate in elderly patients with thoracolumbar fracture after operation,mainly Gram-positive bacteria infection.Clinical measures should be taken to prevent infection according to the risk factors.
作者
吴锦华
张仲华
厉登辉
陈向华
袁志峰
WU Jinhua;ZHANG Zhonghua;LI Denghui;CHEN Xianghua;YUAN Zhifeng(Department of Orthopedics,Hengdian Wenrong Hospital,Dongyang 322118,China;Department of Orthopedics,the First People's Hospital of Jingdezhen,Jingdezhen 333000,China)
出处
《健康研究》
CAS
2021年第3期316-319,323,共5页
Health Research
关键词
胸腰椎骨折
术后感染
病原菌
病原学特点
影响因素
thoracolumbar fracture
postoperative infection
pathogen
pathogenic characteristics
influencing factors
