神经外科手术部位感染风险预警模型的建立与应用  

Establishment and application of an early warning model for surgical site infection in neurosurgery

作　　者：张艳霞[1] 苏梅[1] 魏乐[1] 李方[1] 周媛[1] 杨环[1] 赵庆兰[1] 麻春英[1] 周敏[1] 郭楠[1] ZHANG Yan-xia;SU Mei;WEI Le;LI Fang;ZHOU Yuan;YANG Huan;ZHAO Qing-lan;MA Chun-ying;ZHOU Min;GUO Nan(People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院,乌鲁木齐830001

出　　处：《中国消毒学杂志》2023年第9期684-686,共3页Chinese Journal of Disinfection

基　　金：新疆维吾尔自治区人民医院院内科研项目(20190125)。

摘　　要：目的 了解神经外科患者手术部位感染现状,分析其危险因素,构建手术部位感染风险预警模型,为筛查手术部位感染的高危人群提供技术支持。方法 采用回顾性和前瞻性调查相结合的方法,选择2018—2021年神经外科2 364例手术患者作为研究对象,将数据按6:4的比例随机分为建模组和验证组,通过单因素分析和二元Logistic回归构建预警模型,以ROC曲线下面积(AUC)评价模型的预测效果。结果 2364例神经外科手术患者,发生手术部位感染67例,感染率为2.83%。纳入风险预警模型的变量有低蛋白血症、幕下手术入路、术中放置植入物、术中留置引流管、使用激素、二次手术、术前联合使用抗菌药物等因素;预警模型ROC曲线下面积为AUC=0.938,灵敏度为93.94%,特异度为84.99%。结论 建立的预警模型判别能力较好,对控制手术部位感染、保障患者安全具有重要的现实意义。Objective To understand the status of surgical site infection in neurosurgical patients,and analyze its risk factors,so as to provide technical support for screening high-risk groups of surgical site infection.Methods Using a combination of retrospective and prospective study,2 364 patients who underwent 2021 neurosurgery in 2018 were randomly divided into the modeling group and the Validation Group on a 6:4 ratio,the area under the ROC curve(AUC) was used to evaluate the prediction effect of the model.Results A total of 2 364 neurosurgical patients were investigated,and 67patients had surgical site infections,with an infection rate of 2.83%.The variables included in the risk prediction model were hypoproteinemia,infratentorial surgical approach,intraoperative implant placement,intraoperative indwelling drainage tube,glucocorticoid use,secondary surgery,and preoperative combination of antibacterial drugs.The ROC curve of the warning model was AUC = 0.938,with sensitivity of 93.94% and specificity of 84.99%.Conclusion The early prediction model established in this study has good discriminant ability,which has great practical significance for controlling surgical site infection and ensuring patient safety.

关 键 词：神经外科 手术部位感染 危险因素 

分 类 号：R181.32[医药卫生—流行病学]