闭合性骨盆骨折术后切口感染的病原学及危险因素分析  

Analysis of etiology and risk factors of wound infection after closed pelvic fracture

作　　者：陈钢[1] 黄明伟[1] 孔来法 施涛 方浩 CHEN Gang;HUANG Ming-wei;KONG Lai-fa;SHI Tao;FANG Hao(Emergency Medical Center,Jinhua Central Hospital,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市中心医院急诊医学中心,浙江金华321000

出　　处：《中华全科医学》2020年第7期1128-1130,共3页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2018ZH049)。

摘　　要：目的对闭合性骨盆骨折患者术后发生切口感染的病原学相关危险因素进行分析和探讨,以期降低术后切口感染的发生率。方法选择2013年4月—2019年5月在金华市中心医院收治的406例闭合性骨盆骨折患者,根据术后有无切口感染将其分为感染组(29例,术后发生切口感染)和未感染组(377例,术后未发生切口感染)。对2组合并髋臼骨折、腹部损伤、BMI、创伤严重度评分(ISS)、手术时间、术中失血量、合并脑外伤、合并糖尿病等情况进行统计,并采用单因素和多因素分析研究闭合性骨盆骨折术后切口感染的危险因素,同时记录细菌培养结果。结果406例闭合性骨盆骨折患者有29例发生切口感染,发生率为7.14%(29/406)。单因素分析和多因素logistic回归分析结果显示:合并髋臼骨折(OR=3.111)、腹部损伤(OR=3.475)、BMI(OR=2.053)、ISS评分(OR=2.443)、手术时间(OR=2.366)、术中失血量(OR=2.777)、合并脑外伤(OR=2.254)、合并糖尿病(OR=3.521)是闭合性骨盆骨折术后切口感染的危险因素。结论合并髋臼骨折、腹部损伤、BMI、创伤严重度评分、手术时间、术中失血量、合并脑外伤、合并糖尿病是闭合性骨盆骨折患者发生术后切口感染的危险因素,临床上要重视危险因素,及早做好预防性的治疗,避免闭合性骨盆骨折术后切口感染的发生。Objective To analyze and explore the pathogenic risk factors of incisional infection in patients with closed pelvic fractures to guide clinical treatment,in order to reduce the incidence of postoperative wound infection.Methods A total of 406 patients with closed pelvic fractures admitted to Jinhua Central Hospital of Zhejiang Province from April 2013 to May 2019 were enrolled.Twenty-nine patients with postoperative incision infection were enrolled in the infection group,and 377 patients were treated.Patients who did not have a wound infection were placed in the uninfected group.Statistics were performed on acetabular fractures,abdominal injury,BMI,trauma severity score(ISS),operative time,intraoperative blood loss,combined brain trauma,and diabetes mellitus,and were determined by single factor and multi-variate analysis.Risk factors for wound infection after closed pelvic fracture,and bacterial culture results were recorded.Results There were 29 cases of incisional infection in 406 patients with closed pelvic fracture,the incidence rate was 7.14%(29/406).Univariate and multivariate logistic regression analysis showed that acetabular fractures(OR=3.111),abdominal injury(OR=3.475),BMI(OR=2.053),and ISS(OR=2.443)The operation time(OR=2.366),intraoperative blood loss(OR=2.777),combined brain trauma(OR=2.254),and diabetes mellitus(OR=3.521)were risk factors for wound infection after closed pelvic fracture.Conclusion Combined with acetabular frac-ture,abdominal injury,BMI,ISS,operation time,intraoperative blood loss.Volume,combined with traumatic brain in-jury,and diabetes mellitus are risk factors for postoperative incision infection in patients with closed pelvic fractures.Risk factors should be paid attention to in clinical practice,and preventive treatment should be done early to avoid the oc-currence of wound infection after closed pelvic fracture.

关 键 词：闭合性骨盆骨折 术后切口感染 危险因素 病原学 

分 类 号：R683.3[医药卫生—骨科学] R619.3[医药卫生—外科学]