糖尿病患者脊柱后路内固定术后手术部位感染的危险因素:一项多中心研究  

Risk factors for postoperative surgical site infection following posterior spinal internal fixation surgery in patients with diabetes mellitus:a multicenter study

作　　者：张奎渤[1] 刘辉[2] 刘才俊[3] 陈涛[1] 李国威[1] 郑召民[2] 黄宗文[1] 

机构地区：[1]中山大学附属第五医院骨外科,珠海519000 [2]中山大学附属第一医院脊柱外科,广州510080 [3]广州中医药大学第三附属医院骨科,广州510240

出　　处：《中国矫形外科杂志》2014年第17期1553-1556,共4页Orthopedic Journal of China

基　　金：广东省自然科学基金博士启动项目(编号:S2011040002494);中山大学临床医学研究5010计划项目(编号:2012005)

摘　　要：[目的]探讨糖尿病患者脊柱后路内固定术后发生手术部位感染的危险因素。[方法]回顾性分析三家医院自2011年1月~2013年9月间共322例合并糖尿病的脊柱后路内固定手术患者的临床资料,分为感染组与未感染组,单因素分析对比两组患者在危险因素方面的差异性,并进行Logistic多因素回归分析。[结果]本组322例患者中13例发生手术部位感染,感染率为4.0%。感染组与未感染组单因素分析发现BMI、手术时间、尿蛋白阳性和术前依赖胰岛素等4个指标的差异有统计学意义;多因素回归分析显示,导致手术部位感染的独立危险因素包括BMI（OR=1.867,P=0.032）、尿蛋白阳性（OR=2.978,P=0.001）和手术时间（OR=1.366,P=0.028）。[结论]体重指数、尿蛋白阳性和手术时间是糖尿病患者行脊柱后路内固定术后发生手术部位感染的独立危险因素。[Objective] To evaluate the risk factors for postoperative surgical site infection（ SSI） following posterior spinal internal fixation surgery in patients with diabetes mellitus. [Methods] Between January 2011 and September 2013,322 patients with posterior spinal internal fixations from three hospitals were retrospectively reviewed. Risk factors for SSI were analyzed using univariate analyses and multivariate logistic regression. [Results] The overall rate of SSI was 4. 0%（ 13 /322）. Univariate analyses indicated significant differences in body mass index（ BMI）,duration of surgery,proteinuria,and preoperative insulin dependence. Independent risk factors identified by multivariate analysis were BMI（ OR = 1. 867,P = 0. 032）,proteinuria（ OR =2.978,P =0.001）,and duration of surgery（ OR =1.366,P =0.028）. [Conclusion] BMI,proteinuria,and duration of surgery are independent risk factors for postoperative SSI following posterior spinal internal fixation surgery in patients with diabetes mellitus.

关 键 词：糖尿病 脊柱 内固定 手术部位感染 危险因素 

分 类 号：R687.3[医药卫生—骨科学]