成人股骨颈骨折术后切口部位感染的风险因素分析  

A study on risk factors of incision infection in adults with femoral neck fracture

作　　者：乐礼祥 丁健[1] 洪克建 顾本进 刘文虎[1] 陈诚[1] LE Li-xiang;DING Jian;HONG Ke-jian;GU Ben-jin;LIU Wen-hu;CHEN Cheng(Department of Orthopaedics,Rugao People’s Hospital,Rugao,Jiangsu,226500,China)

机构地区：[1]如皋市人民医院骨科

出　　处：《中国骨与关节杂志》2020年第1期45-48,共4页Chinese Journal of Bone and Joint

摘　　要：目的探讨成人股骨颈骨折术后切口部位感染的危险因素。方法对 2016 年 4 月至 2019 年 1 月因股骨颈骨折入院手术治疗的 400 例患者资料进行分析,其中男 188 例,女 212 例;年龄 65~88 岁,平均 (78.3±10.6) 岁。按致伤原因分为:跌倒伤 93 例、车祸伤 58 例、外伤 249 例。按照术后是否存切口部位感染,分为感染组 (n=382) 和未感染组 (n=18)。通过单因素和多因素分析确定切口部位感染的相关危险因素。结果单因素分析结果显示,多发损伤、肥胖 (BMI ≥ 28)、风湿病、服用激素及贫血史均是切口部位感染的危险因素 (P<0.05),而其它变量均与切口部位感染的发生不相关。多因素分析结果显示 BMI ≥ 28、糖尿病、服用激素、贫血及术前血红蛋白水平均是切口部位感染的独立危险因素 (P<0.05)。Hosmer-Lemeshow 检验结果显示多因素回归模型的拟合优度可 (χ^2=9.645,P=0.213)。结论糖尿病、BMI ≥ 28、皮质类固醇激素及贫血均是股骨颈骨折患者术后切口部位感染的独立危险因素。Objective To investigate risk factors of incision infection in adults with femoral neck fracture.Methods A total of 400 adults (188 males,212 females) with femoral neck fracture were enrolled from April 2016 to January 2019.The mean age was (78.3±10.6) years (range:65-88 years).Causes of injury:93 cases of fall injury,58 cases of car accident,and 249 cases of trauma.All patients after total hip replacement were divided into infected group (n=382) and uninfected group (n=18).Univariate and multivariate analyses were used to determine the risk factors associated with the infection.Results Univariate analysis showed that multiple injuries,obesity (BMI ≥28),rheumatism,hormones,and anemia were risk factors for the infection (P < 0.05),while other variables not.Multivariate analysis showed that obesity (BMI ≥ 28),diabetes,hormones,anemia,and preoperative hemoglobin levels were independent risk factors for the infection (P < 0.05).Hosmer-Lemeshow results suggested that the goodness of fit of the multivariate regression model was fair (χ^2=9.645,P=0.213).Conclusions Diabetes,obesity(BMI ≥ 28),hormones,and anemia are independent risk factors for the postoperative incision infection in adults with femoral neck fracture.

关 键 词：股骨颈骨折 外科伤口 感染 危险因素 

分 类 号：R683.4[医药卫生—骨科学]