摘要
目的分析毒蛇咬伤患者创面感染的影响因素,并构建Logistic回归方程.方法回顾性收集2018年3月-2022年10月达州市中心医院收治的409例毒蛇咬伤患者临床资料,根据患者是否发生创面感染分为感染组68例和未感染组341例,分析毒蛇咬伤患者创面感染的影响因素,并构建回归方程,采用受试者工作特征(ROC)曲线分析回归方程的预测价值.结果伤口切开、溃疡程度为Ⅱ度或Ⅲ度溃疡、使用抗蛇毒血清为毒蛇咬伤患者创面感染的独立危险因素(P<0.05),预防性使用抗菌药物为毒蛇咬伤患者创面感染的保护因素(P<0.05);根据多因素分析结果构建回归方程:Logit(P)=-3.552+伤口切开×0.983+溃疡程度×1.192+使用抗蛇毒血清×1.072-预防性使用抗菌药物×0.846;ROC曲线分析结果显示,当Logit(P)>12.83时,曲线下面积(AUC)为0.916,敏感度为85.29%,特异度为82.40%.结论毒蛇咬伤患者创面感染的独立危险因素包括伤口切开、溃疡程度为Ⅱ度或Ⅲ度溃疡和使用抗蛇毒血清,预防性使用抗菌药物为毒蛇咬伤患者创面感染的保护因素,相关回归方程对毒蛇咬伤患者创面感染的预测价值较好.
OBJECTIVE To analyze the influencing factors for wound infection in the patients with poisonous snake bit and establish the logistic regression equation.METHODS The clinical data were retrospectively collected from 409 patients with poisonous snake bite who were treated in Dazhou Central Hospital from Mar 2018 to Oct 2022,the patients were divided into the infection group with 68 cases and the no infection group with 341l cases according to the status of wound infection.The influencing factors for the wound infection in the patients with poisonous snake bite were analyzed,the regression equation was established,and the predictive value of the regression equation was analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Wound incision,Ⅰdegree orⅡdegree ulcer,and use of antivenin were independent risk factors for wound infection in the patients with poisonous snake bite;prophylactic use of antibiotics was the protective factor for wound infection(P<0.05).The regression equation was established based on the result of multivariate analysis:Logit(P)=-3.552+wound incisionX0.983+ulcer degree×1.192+use of antivenin×1.072-prophylactic use of antibiotics×0.846.The result of ROC curve analysis showed that when the Logit(P)was more than 12.83,the area under curve(AUC)was 0.916,with the sensitivity 85.29%,the specificity 82.40%.CONCLUSION The independent risk factors for the wound infection in the patients with poisonous snake bite include the wound incision,Ⅱdegree orⅢdegree ulcer and use of antivenin.The prophylactic use of antibiotics is the protective factor for the wound infection.The re-gression equation has high value in prediction of wound infection in the patients with poisonous snake bite.
作者
杨国成
赵海涛
马梁策
王伟
冉小于
YANG Guo-cheng;ZHAO Hai-tao;MA Liang-ce;WANG Wei;RAN Xiao-yu(Dazhou Central Hospital,Dazhou,Sichuan 635000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第17期2688-2692,共5页
Chinese Journal of Nosocomiology
基金
四川省科研基金资助项目(2020JG02411)。
关键词
毒蛇
咬伤
创面感染
危险因素
预测模型
Poisonous snake
Bite
Wound infection
Risk factor
Prediction model
