腰椎间盘突出症术后椎间隙感染病原菌分布及影响因素分析  

An Analysis of Pathogenic Bacteria Distribution and Influencing Factors of Intervertebral Space Infection After Lumbar Disc Herniation

作　　者：赵兵[1] 黄海锋[1] 尹振宇[1] 羊刚毅[1] 宋晋刚[1] ZHAO Bing;HUANG Haifeng;YIN Zhenyu(Mianyang Central Hospital, Sichuan Mianyang 621000,China)

机构地区：[1]四川省绵阳市中心医院脊柱外科,四川绵阳621000

出　　处：《河北医学》2021年第4期620-625,共6页Hebei Medicine

基　　金：四川省绵阳市科技计划项目,(编号:17S-ZC-02)。

摘　　要：目的:探究腰椎间盘突出症(LDH)术后并发椎间隙感染的病原菌分布情况,并分析其影响因素。方法:从2013年3月至2020年3月我院收治且行手术治疗的LDH患者中筛选出895例,以是否术后并发椎间隙感染为依据,划分为观察组(并发感染者,38例)与对照组(未并发感染者,857例)。统计LDH术后并发椎间隙感染及其病原菌分布情况,并回顾两组临床资料,进行影响因素分析。结果:895例LDH患者中,术后并发椎间隙感染有38例(4.25%);8例未能检测出病原菌,另外30例检测出病原菌33株,金黄色葡萄球菌检出率最高,所占比例为30.30%,其次分别为表皮葡萄球菌(21.21%)与大肠埃希菌(15.15%)。单因素结果显示,年龄、糖尿病史、BMI、营养不良、手术时间、术后合并其他系统感染为LDH术后并发椎间隙感染的影响因素。多因素Logistic回归分析显示,≥55岁、有糖尿病史、BMI≥27kg/m2、营养不良、手术时间≥3h、术后合并其他系统感染为LDH术后并发椎间隙感染的独立危险因素。结论:临床上LDH术后不易并发椎间隙感染,发生率在低水平,但在术后康复过程中仍需对并发椎间隙感染的独立危险因素给予重点关注,并且可基于病原菌分布情况合理应用抗生素加以预防,规范操作从而减少或避免术后椎间隙感染情况。Objective:To explore the distribution of pathogenic bacteria associated with intervertebral space infection after lumbar disc herniation(LDH)and analyze its influencing factors.Methods:From March 2013 to March 2020,895 patients with LDH who were admitted to our hospital and underwent surgical treatment were screened out.Based on whether they had postoperative complications of intervertebral space infection,they were divided into observation group(complicated infection,38 cases)and control group(857 cases without concurrent infection).Statistics of postoperative LDH complicated intervertebral space infection and the distribution of pathogenic bacteria were recorded,the clinical data of the two groups were reviewed,and the influencing factors were analyzed.Results:Among the 895 cases of LDH patients,38 cases(4.25%)had postoperative complications of intervertebral space infection,8 cases failed to detect pathogenic bacteria,and 33 pathogenic bacteria were detected in the other 30 cases.The detection rate of Staphylococcus aureus was the highest,accounting for 30.30%,followed by Staphylococcus epidermidis(21.21%)and Escherichia coli(15.15%).The univariate results showed that age,history of diabetes,BMI,malnutrition,operation time,and postoperative infections of other systems were the influencing factors of intervertebral space infection after LDH.Multivariate logistic regression analysis showed that age≥55 years old,history of diabetes,BMI≥27kg/m2,malnutrition,operation time≥3h,postoperative infection of other systems were independent risk factors for postoperative LDH complicated with intervertebral space infection.Conclusion:In clinical practice,LDH is not easy to be complicated with intervertebral space infection,and the incidence is at a low level.However,it is still necessary to pay attention to the independent risk factors of complicated intervertebral space infection during postoperative rehabilitation,and it can be reasonably applied based on the distribution of pathogens.Antibiotics are used to prevent

关 键 词：腰椎间盘突出症 术后椎间隙感染 病原菌 影响因素 危险因素 

分 类 号：R68[医药卫生—骨科学]