不同体重指数与骨折患者手术部位感染的关系  

Relationship between body mass index and surgical site infections in fracture patients

作　　者：牟哲飞[1] 倪跃平[1] 叶秀云[1] 郑均炬[1] 

机构地区：[1]温州医学院定理临床学院创伤外科,浙江温州325000

出　　处：《中华医院感染学杂志》2013年第17期4178-4180,共3页Chinese Journal of Nosocomiology

基　　金：浙江省温州市科技局科研项目(Y20130098)

摘　　要：目的探讨体重指数（BMI）与骨折患者手术部位感染的关系，以了解BMI在术后感染中的作用。方法选择894例接受骨科急性手术治疗的非糖尿病骨折患者为研究对象，根据患者BMI水平分为A组（BMIC＜18. 5）123 例，B 组（BMI 18. 5-24. 9）349 例，C 组（BMI 25-29. 9）321 例，D 组（BMI30-39. 9）70 例，E 组（BMI≥40）31例，分别观察各组术后30 d手术部位感染发生情况。结果随着BMI的增加，患者手术时间从A组（3. 6±2. 2）h到E组的（8. 4±3. l）h、术后住院天数从A组（13. 2±10. 2）d到E组的（28. 3±15. 7）d及手术后创口轻度感染的概率从9. 8%到35. 4%，重度感染从0-33. 3%，均显著增加（P〈0. 05），并且与手术部位感染发生率呈正相关（R=0.977，P〈0.01）。结论BMI可能是骨折患者手术部位感染发生的原因之一，建议重点监测高BMI指数的患者以降低术后感染的发生。OBJECTIVE To probe into the relationship between the body mass index （BMI） and the surgical site in-fections in fracture patients so as to understand the role of BMI in the postoperative infections. METHODS A totalof 894 cases of non-diabetic patients who underwent emergency orthopaedic injuries were enrolled in the study,then the patients, according to the level of BMI, were divided into the group A with 123 cases （BMI less than18. 5%）,the group B with 349 cases （BMI ranging between 18. 5 and 24. 9）,the group C with 321 cases （BMIranging between 25 and 29. 9）,the group D with 70 cases （BMI ranging between 30 and 39. 9）,and the group Ewith 31 cases （BMI more than 40）; the incidence of surgical site infections 30 days after the surgery wasobserved. RESULTS With the increase of BMI, the duration of operation increased from （3. 6±2, 2）h of the groupA to （8. 4 ±3. 1）h of the group E,postoperative hospitalization duration increasing from （13. 2±10. 2） d of thegroup A to （28. 3± 15. 7）d of the group E; the incidence of postoperative mild wound infections increased from9. 8% to 35. 4 %, with the incidence of severe infections increasing from 0 to 33. 3% （P〈0. 05）, which was posi-tively correlated with the incidence of the surgical site infections （R=0. 977,P〈0. 01）. CONCLUSION BMI maybe one of the causes of the surgical site infections in the fracture patients, it is suggested that the patients withhigh BMI should be monitored so as to reduce the incidence of postoperative infections.

关 键 词：体重指数 骨折手术 术后感染 

分 类 号：R619.3[医药卫生—外科学]