脊柱手术患者切口感染相关因素分析  

Risk factors analysis of spinal surgery incision infections

作　　者：聂燕[1] 应秀华[2] 彭根英[3] 张凌[1] 吴斌 

机构地区：[1]丽水市人民医院骨科,浙江丽水323000 [2]丽水市人民医院护理部,浙江丽水323000 [3]丽水市人民医院院感科,浙江丽水323000 [4]绍兴市中心医院骨科,浙江绍兴312030

出　　处：《中华医院感染学杂志》2015年第4期882-884,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生基金资助项目(2012RQE108)

摘　　要：目的探讨脊柱手术患者切口感染病原菌构成、危险因素及治疗方法,为预防与治疗提供依据。方法选取2011年1月-2013年12月医院的651例脊柱手术患者,收集切口感染患者体液标本进行病原菌分离鉴定,并对其进行切开引流、彻底清创、灌洗引流,抗菌药物静脉滴注等对症治疗,同时统计分析脊柱手术患者的临床资料,探讨脊柱手术切口发生感染危险因素。结果 651例脊柱手术患者发生感染10例,感染率为1.54%;切口感染患者送检标本共分离出病原菌13株,革兰阴性菌占76.93%、革兰阳性菌占23.07%;切口感染患者治疗后随访6-24个月,10例切口感染患者全部痊愈;多因素logistic回归分析共筛选出4个独立危险因素,分别为年龄、合并糖尿病、体重指数、手术时间。结论脊柱手术患者术后切口感染病原菌以革兰阴性菌为主,切开引流、内固定取出、彻底清创、灌洗引流,抗菌药物静脉滴注可有效治疗切口感染,年龄、合并糖尿病、体质量指数、手术时间为脊柱手术患者发生切口感染的危险因素。OBJECTIVE To explore pathogens constitution,risk factors and treatment methods of spinal surgery incision infections,providing basis for the prevention and treatment.METHODS Totally 651 cases of spinal surgery patients in our hospital from Jan.2011 to Dec.2013 were selected.Samples of body fluids from patients who underwent incision infections were collected and done pathogens isolation and identification,and then they were given incision and drainage,debridement,lavage,intravenous antibiotics for treatment.Meanwhile,clinical data of 651 cases of spinal surgery were analyzed to explore the risk factors of infections.RESULTS A number of 10 infected patients in 651 cases of spinal surgery patients were infected,the infection rate was 1.54%.Totally 13 pathogens were isolated from of the samples of incision infection patients.Gram-negative bacteria accounted for76.93%,and gram-positive bacteria accounted for 23.07%.Incision infected patients were followed up from 6to24 months,and the 10 cases of incision infections were all healed.Multivariate logistic regression analysis screened out four independent risk factors：age,combined diabetes,body mass index,operation time.CONCLUSIONSpinal surgery postoperative infection pathogens mainly are gram-negative bacteria.Incision and drainage,debridement,lavage,and intravenous antibiotics can be effective treatment for incision infection.Age,combined diabetes,body mass index,and operative time are risk factors for spinal surgery incision infections.

关 键 词：脊柱手术 切口感染 危险因素 对策 

分 类 号：R619.3[医药卫生—外科学]