严重颈椎病前后路联合手术患者术后医院感染的病原学特点与危险因素分析  

Etiological characteristics and risk factors of postoperative nosocomial infection in patients with severe cervical spondylosis myelorathy treated by anterior and posterior approach surgery

作　　者：刘建坤[1] 邓树才[1] 马毅[1] 贾占华[1] 赵合元[1] 

机构地区：[1]天津医院脊柱外科,天津300211

出　　处：《中华医院感染学杂志》2017年第15期3518-3521,共4页Chinese Journal of Nosocomiology

基　　金：天津市应用基础研究计划面上资助项目(06YFJMJC10100)

摘　　要：目的探讨严重颈椎病前后路联合手术患者术后医院感染的病原学特点及危险因素分析,为临床治疗提供参考依据。方法选择2005年1月-2015年12月于医院行前后路联合手术治疗的严重颈椎病(脊髓型)的患者212例,对患者医院感染的病原菌特点以及对导致感染发生的相关危险因素进行分析。结果 212例严重颈椎病(脊髓型)患者,发生医院感染30例,感染率为14.2%;共检出病原菌42株,以革兰阳性菌为主,共22株占52.4%;革兰阳性菌对亚胺培南和万古霉素有着较高的敏感性,敏感率为100.0%;是否合并基础疾病、经验性抗菌药物使用情况、住院时间、手术时间以及术中出血量为患者发生医院感染的独立危险因素(P<0.05)。结论可依据术后导致患者感染的相关危险因素,建立完善的治疗护理体系和严格的无菌操作流程以及营造洁净舒适的生活环境来进行相应预防。OBJECTIVE To investigate the etiological characteristics and risk factors of postoperative nosocomial infections in patients with severe cervical spondylosis myelorathy treated by anterior and posterior approach surgery,so as to provide references for clinical treatment.METHODS A total of 212 patients with severe cervical spondylotic myelopathy from Jan.2005 to Dec.2015 were enrolled in this study.The characteristics of pathogens and risk factors of inpatients with nosocomial infections were analyzed.RESULTS Among the 212 patients with severe cervical spondylotic myelopathy,30 cases of patients occurred nosocomial infections,and the infection rate was 14.2% .Totally 42 strains of pathogens were detected,which were mainly 22 strains of gram-positive bacteria,accounting for 52.4% .Gram-positive bacteria had high sensitivity to imipenem and vancomycin,and the sensitive rate were 100% .Combination of underlying diseases,use of empirical antimicrobial agents,length of hospital stay operation duration and intraoperative bleeding volume were the independent risk factors for nosocomial infections（P〈0.05）.CONCLUSION According to the related risk factors of postoperative infections,we should establish a perfect nursing and treatment system and strict aseptic operation process.

关 键 词：颈椎病 前后路联合手术 医院感染 病原学 危险因素 

分 类 号：R687.3[医药卫生—骨科学]