腰椎间盘突出症患者术后椎间隙感染发生情况及危险因素分析  

Analysis of incidence and risk factors of intervertebral space infection in patients with lumbar disc herniation after operation

作　　者：李大猛[1] 鲁锋[1] 田云[1] 李德广[1] 阎辉 李守刚 LI Da-meng;LU Feng;TIAN Yun;LI De-guang;YAN Hui;LI Shou-gang(Department of Orthopaedics,the People’s Hospital of Zunhua,Tangshan,Hebei 064200,China)

机构地区：[1]河北省唐山市遵化市人民医院骨二科,河北唐山064200

出　　处：《颈腰痛杂志》2020年第2期140-142,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨腰椎间盘突出症患者术后椎间隙感染的发生情况及危险因素。方法选取2013年1月-2019年1月本院手术治疗的932例腰椎间盘突出症患者,根据其是否发生术后感染分为感染组(34例)以及未感染组(898例)。分析感染组患者病原菌分布,回顾性收集两组患者临床资料,并进行危险因素分析。结果34例术后发生椎间隙感染,感染率3.65%。其中25例患者在有氧条件下培养出病原菌26株,检出率最高的为金黄色葡萄球菌,占30.77%,其次为大肠埃希菌(19.23%)和表皮葡萄球菌(15.38%)。多因素Logistic回归分析显示,年龄≥55岁、有糖尿病史、体质量指数(BMI)≥27 kg/m^2、营养不良、手术时间≥3 h、术后合并其他系统感染为腰椎间盘突出症患者术后椎间隙感染发生的独立危险因素(P<0.05)。结论腰椎间盘突出症患者术后椎间隙感染发生率较低,但临床仍应重视患者发生椎间隙感染的危险因素,可针对其病原菌分布预防性应用抗生素,并进一步规范相关诊疗和护理操作,减少术后椎间隙感染的发生。Objective To explore the incidence and risk factors of intervertebral space infection in patients with lumbar disc herniation(LDH)after operation.Methods From January 2013 to January 2019,932 patients with LDH who were treated by operation in our hospital were selected.According to whether the postoperative infection occurred or not,the patients were divided into the infection group(34 cases)and the non-infection group(898 cases).The distribution of pathogenic bacteria in the infection group was analyzed.The clinical data of the two groups were collected retrospectively and the risk factors were analyzed.Results Among 932 patients with LDH,34 patients had intervertebral space infection after operation,the infection rate was 3.65%.Among them,26 strains of pathogenic bacteria were cultured in 25 patients under aerobic conditions,the highest detection rate was Staphylococcus aureus(30.77%),followed by Escherichia coli(19.23%)and Staphylococcus epidermidis(15.38%).Multivariate Logistic regression analysis showed that age≥55 years,diabetes history,body mass index(BMI)≥27 kg/m^2,malnutrition,operation time≥3 h,complicated with other systemic infections were independent risk factors for postoperative intervertebral space infection in patients with LDH(P<0.05).Conclusion The incidence of postoperative intervertebral space infection in patients with LDH is low,but clinical attention should still be paid to the risk factors of intervertebral space infection,which can be used prophylactically for the distribution of pathogenic bacteria,and further standardize the relevant diagnosis and treatment and nursing operation to reduce the incidence of postoperative intervertebral space infection.

关 键 词：腰椎间盘突出症 椎间隙感染 病原菌分布 危险因素 

分 类 号：R681.53[医药卫生—骨科学]