布鲁氏杆菌性脊柱炎术后伤口不愈合的危险因素分析  

Factors associated with non-healing wounds after brucellosis spondylitis

作　　者：魏萌[1] 柳洪宙[2] 王磊[3] WEI Meng;LIU Hongzhou;WANG Lei(The Third Department of Orthopedics,Central Hospital of Handan City,Handan 056001,Hebei Province,China;Department of Endocrinology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Orthopedics,the Fourth Medical Center,Chinese PLA General Hospital,Beijing 100048,China)

机构地区：[1]邯郸市中心医院骨科三病区,河北邯郸056001 [2]解放军总医院第一医学中心内分泌科,北京100853 [3]解放军总医院第四医学中心骨科医学部,北京100048

出　　处：《解放军医学院学报》2021年第10期1020-1024,1052,共6页Academic Journal of Chinese PLA Medical School

摘　　要：背景布鲁氏杆菌性脊柱炎作为布鲁氏杆菌引起的一种传染性变态反应性疾病,其治疗方式主要为手术治疗和保守药物治疗。布鲁氏杆菌性脊柱炎患者手术切口为非清洁切口,术后易发生伤口不愈合。目的本研究通过分析布鲁氏菌性脊柱炎患者术后伤口不愈合的危险因素,为预防该类患者术后伤口不愈合提供参考。方法该研究纳入2013年1月-2018年1月于邯郸市中心医院行手术治疗的布鲁氏菌性脊柱炎患者94例。记录患者的基本资料及围术期相关指标。应用多因素logistic回归分析布鲁氏杆菌性脊柱炎患者术后伤口不愈合的危险因素。结果 94例患者中男54例,女40例,年龄(47.36±7.32)岁。13例(13.83%)出现术后伤口不愈合。年龄(OR:1.135,95%CI:1.032~1.248,P=0.009)、合并糖尿病(OR:9.020,95%CI:1.294~62.885,P=0.026)、手术病灶清除程度(OR:20.911,95%CI:1.908~229.141,P=0.013)和血白蛋白水平(OR:0.776,95%CI:0.664~0.907,P=0.001)是布鲁氏杆菌性脊柱炎患者术后伤口不愈合的危险因素。结论高龄、合并糖尿病、手术病灶清除不彻底及血白蛋白水平降低是布鲁氏杆菌性脊柱炎患者术后伤口不愈合的危险因素。合理选择手术适应证是降低术后伤口不愈合发生率的关键。Background Brucella spondylitis is an infectious allergic disease caused by Brucella.Its treatment methods are mainly divided into surgical treatment for debridement and conservative drug treatment.For the surgical incisions of patients with Brucella spondylitis are non-clean incisions,the wound will not heal after surgery.Objective To analyze the factors associated with postoperative non-healing wound in patients with brucellosis spondylitis,and provide evidence to reduce the incidence of postoperative non-healing wound in this disease.Methods Totally 94 patients with Brucella spondylitis who underwent surgical treatment in our hospital from January 2013 to January 2018 were enrolled in this study.The patients’ basic information and perioperative information were recorded.Multivariate logistic regression analysis was used to analyze the risk factors of wound nonhealing in patients with Brucella spondylitis.Results Of the 94 cases(54 males and 40 females,average age of 47.36±7.32 years old),wound non-healing was found in 13 patients(13.83%).Age(OR:1.135,95% CI:1.032-1.248,P=0.009),combined diabetes(OR:9.020,95% CI:1.294-62.885,P=0.026),extent of resection of involved site(OR:20.911,95% CI:1.908-229.141,P=0.013)and blood albumin level(OR:0.776,95% CI:0.664-0.907,P=0.001) were risk factors of postoperative non-healing wound in patients with Brucella spondylitis.Conclusion Elderly patients,combined diabetes,incomplete resection of involved site and decreased blood albumin levels are risk factors for postoperative wound non-healing of Brucella spondylitis.Reasonable choice of surgical indications is the key to reduce incidence of wound non-healing after operation.

关 键 词：脊柱 布鲁氏菌病 手术 伤口不愈合 危险因素 

分 类 号：R681.51[医药卫生—骨科学]