脊柱术后医院感染特征及影响因素分析  

Characteristics and Analysis of Risk Factors of Nosocomial Infection after Spinal Surgery

作　　者：张丹梅[1] 袁丽 朱琪[1] ZHANG Danmei;YUAN Li;ZHU Qi(Department of Nosocomial Infection,the General Hospital of Ningxia Medical University,Yinchuan 750004,China;The Second People's Hospital of Yinchuan,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院院内感染科,银川750004 [2]银川市第二人民医院,银川750004

出　　处：《宁夏医科大学学报》2022年第11期1134-1139,共6页Journal of Ningxia Medical University

摘　　要：目的分析脊柱术后医院感染特征及其影响因素,为临床感染防控提供科学依据。方法选取我院2020年1月至2021年12月实施脊柱手术的599例患者作为研究对象,对术后感染发生情况、感染部位分布、病原菌构成情况及相关危险因素进行回顾性分析。结果术后医院感染患者39例(6.51%);肺部感染和手术部位感染为主要感染部位,感染部位构成比分别为34.15%和31.71%;检出的10株感染病原菌中革兰氏阳性菌占60.00%,革兰氏阴性菌占40.00%,其中常见病原菌以金黄色葡萄球菌、凝固酶阴性葡萄球菌和大肠埃希菌为主,构成比分别为30.00%、20.00%和20.00%;Logistic多因素回归分析结果显示,术前低蛋白、手术风险分级≥1分、脑脊液漏是脊柱术后发生医院感染的独立危险因素(P<0.05)。结论脊柱术后医院感染以肺部和手术部位感染为主,革兰氏阳性菌为主要病原菌类型,脊柱术后医院感染危险因素较多,应采取围手术期管理模式,联合术前、术中及术后各项防控措施来降低术后感染的发生。Objective To analyze the characteristics and risk factors of nosocomial infection after spinal surgery,so as to provide scientific basis for prevention and control of clinical infection.Methods A total of 599 patients underwent spinal surgery in our hospital from Jan 2020 to Dec 2021 were included in our study.The incidence of postoperative infection,the distribution of infection sites,pathogen composition and related risk factors were analyzed retrospectively.Results Postoperative infections occurred in 39 cases complicated with postoperative infections,and the infection rate was 6.51%.The main sites of infection were lung and surgical site,with a ratio of 34.15%and 31.71%,respectively.Ten strains of pathogens were detected,among which gram-positive bacteria accounted for 60.00%and gram-negative bacteria accounted for 40.00%.The main pathogens were Staphylococcus aureus,coagulase negative staphylococcus and Escherichia coli,with composition ratios of 30.00%,20.00%and 20.00%,respectively.Multivariate Logistic regression analysis showed that low preoperative protein,surgical risk grade≥1,and cerebrospinal fluid leakage were independent risk factors for nosocomial infection after spinal surgery(P<0.05).Conclusion Nosocomial infection after spinal surgery mainly involved pulmonary infection and surgical site infection.Gram-positive bacteria was the main pathogen.There are many risk factors for nosocomial infection after spinal surgery,so perioperative management should be adopted,combined with preoperative,intraoperative and postoperative prevention and control measures to reduce the incidence of postoperative infection.

关 键 词：脊柱手术 医院感染 危险因素 围手术期管理 

分 类 号：R619.3[医药卫生—外科学]