老年病人脊柱手术后切口感染的病原菌分布及危险因素分析  

Analysis of pathogens distribution and risk factors of incision infection in elderly patients after spinal surgery

作　　者：曹波 桂光明 黄琛 杨建 李强 CAO Bo;GUI Guang-ming;HUANG Chen;YANG Jian;LI Qiang(Department of Spine Trauma,The Traditional Chinese Medicine Hospital of Yangxin,Huangshi Hubei 435200,China)

机构地区：[1]鄂东医疗集团黄石市中医医院脊柱创伤骨科,湖北黄石435000 [2]湖北省阳新县中医院,435200

出　　处：《蚌埠医学院学报》2018年第11期1481-1483,共3页Journal of Bengbu Medical College

摘　　要：目的:分析老年病人脊柱手术后切口感染的病原菌分布特点及相关危险因素,为临床防治脊柱术后感染提供依据。方法:回顾性分析569例行脊椎手术的住院老年病人的临床资料,分析术后切口感染的病原菌分布特点,并采用单因素分析和多因素logistic回归分析探讨术后切口感染的相关危险因素。结果:569例老年病人中术后感染24例,感染率为4. 22%。共检出31株病原菌,其中革兰阴性菌21株(67. 74%),革兰阳性菌9株(29. 03%),真菌1株(3. 23%)。单因素分析结果显示,营养不良、体质量指数≥28 kg/m2、手术时间≥150 min、侵入性操作、使用内固定器材、合并糖尿病均与老年脊柱手术后切口感染相关(P <0. 05～P <0. 01);多因素logistic回归分析结果显示,体质量指数≥28 kg/m2、手术时间≥150 min、合并糖尿病均为老年脊柱手术后切口感染的独立危险因素(P <0. 05～P <0. 01)。结论:老年病人脊柱手术后切口感染的病原菌种类较广,术后切口感染相关危险因素较多,应采取针对性措施,合理选用抗菌药物,以降低感染率。Objective： To explore the pathogens distribution and risk factors of incision infection in elderly patients after spinal surgery. Methods： The clinical data of 569 elderly patients treated with spinal surgery were retrospectively analyzed. The distribution of pathogens in infection incision was analyzed. The risk factors of incision infection in elderly patients after spinal surgery were analyzed using the univariate and multivariate logistic regression analysis. Results： Among 569 elderly patients treated with spinal surgery,24 patients were infected,and the infection rate was 4. 22%. Thirty-one pathogens were found,which included 21 strains（ 67. 74%） of gram-negative bacteria,9 strains（ 29. 03%） of gram-positive bacteria,and 1 strain（ 3. 23%） of fungi. The univariate analysis showed that the malnutrition,BMI≥28 kg/m^2,operative time≥150 min,invasive procedures,internal fixation devices and diabetes were the risk factors of spinal surgical incision infection（ P〈0. 05 to P〈0. 01）. The multivariate logistic regression analysis showed that the BMI≥28 kg/m^2,operation time≥150 min and diabetes were the independent risk factors of spinal surgical incision infection in elderly patients（ P〈0. 05 to P〈0. 01）. Conclusions： The pathogen of incision infection of spinal surgery is wide in elderly patients,and the risk factors associated with postoperative infection is various. The targeted measures and rational antimicrobial agents should be used to reduce the infection rate.

关 键 词：脊柱手术 手术切口感染 病原菌 危险因素 

分 类 号：R681.5[医药卫生—骨科学]