骨外固定架针孔感染风险预测模型的构建  

Construction of risk prediction model for pinhole infection of orthopedic external fixators

作　　者：郭凡依 高钰琳[2] 赵婷 马玥[2] 余文娟 杨静华[4] 刘树霞[4] 彭小伟[4] Guo Fanyi;Gao Yulin;Zhao Ting;Ma Yue;Yu Wenjuan;Yang Jinghua;Liu Shuxia;Peng Xiaowei(Department of Otolaryngology and Ophthalmology,Shenzhen Hospital of Southern Medical University,Shenzhen 518101,China;School of Nursing,Southern Medical University,Guangzhou 510515,China;School of Nursing and Rehabilitation,Xi'an Medical University,Xi'an 710021,China;Department of Trauma and Orthopedics,Southern Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学深圳医院耳鼻喉眼科,深圳518101 [2]南方医科大学护理学院,广州510515 [3]西安医学院护理与康复学院,西安710021 [4]南方医科大学南方医院创伤骨科,广州510515

出　　处：《中华现代护理杂志》2023年第6期781-786,共6页Chinese Journal of Modern Nursing

基　　金：2018南方医科大学科研启动计划(青年项目)(G618329146)。

摘　　要：目的了解骨外固定支架患者发生针孔感染的风险因素,并构建其风险预测模型。方法采用回顾性调查法选取2018年1月—2019年6月南方医科大学南方医院创伤骨科行外固定支架患者(n=300)的资料,以术后病例记录中是否发生针孔感染分为感染组和非感染组。采用单因素分析和Logistic回归分析确立发生针孔感染的风险因素,建立预测模型,同时采用赋值法构建风险预测等级分级。结果300例骨外固定支架患者中,发生针孔感染者103例(34.33%),未发生感染者197例(65.67%)。Logistic回归分析显示,基础疾病[OR=4.726(糖尿病、肺部感染之一)、17.053(糖尿病、肺部感染、心血管疾病之二)]、术后白蛋白水平[OR=0.082(<25 g/L)]、术后血红蛋白水平[OR=3.715(>90~120 g/L)、9.720(>60~90 g/L)、7.338(30~60 g/L)]、术中出血量[OR=2.196(200~400 ml)、OR=3.256(>400 ml)]及消毒液类别[OR=3.897(氯己定)、3.625(碘伏+氯己定)]是骨外固定支架患者发生针孔感染的危险因素(P<0.05)。构建出模型≥7分为高风险组,5~6分为较高风险组,4分为中风险组,3分为低风险组,0~2分为较低风险组。结论该模型能较好地预测骨科外固定架患者发生针孔感染的风险,为医护人员及时识别外固定感染风险提供参考,尽早预防感染的发生。Objective To explore the risk factors of pinhole infection in patients with external fixators,and build a risk prediction model.Methods From January 2018 to June 2019,the data of patients(n=300)with external fixators in the Department of Trauma and Orthopedics,South Hospital,South Medical University,were selected by retrospective survey,and were divided into infection group and non-infection group according to whether pinhole infection occurred in the postoperative case records.Single factor analysis and Logistic regression analysis were used to establish the risk factors of pinhole infection and its prediction model.The grade of risk prediction was constructed by the assignment method.Results Among 300 patients with external fixators,103(34.33%)had pinhole infection and 197(65.67%)had no infection.Logistic regression analysis showed that basic disease[OR=4.726(one of diabetes,pulmonary infection),17.053(two of diabetes,pulmonary infection,cardiovascular diseases)],postoperative albumin[OR=0.082(<25 g/L)],postoperative hemoglobin[OR=3.715(>90-120 g/L),9.720(>60-90 g/L),7.338(30~60 g/L)],intraoperative bleeding volume[OR=2.196(200-400 ml),OR=3.256(>400 ml)]and the type of disinfectant[OR=3.897(chlorhexidine),3.625(iodophor+chlorhexidine)]were risk factors for pinhole infection in patients with external fixators(P<0.05).The constructed model was divided into high-risk group(≥7 points),higher-risk group(5-6 points),medium-risk group(4 points),low-risk group(3 points)and lower-risk group(0-2 points).Conclusions The model can well predict the risk of pinhole infection of orthopedic external fixator,provide reference for medical and nursing staff to identify the risk of external fixation infection in time,and prevent the occurrence of infection as soon as possible.

关 键 词：骨科 外固定器 针孔感染 等级 预测模型 

分 类 号：R687[医药卫生—骨科学]