踝关节骨折切开复位内固定术后感染发生情况及影响因素分析  

Analysis of infection and its influencing factors after open reduction and internal fixation of ankle fracture

作　　者：王宇婷 赵媛 杨勇昆 WANG Yuting;ZHAO Yuan;YANG Yongkun(Department of Foot and Ankle Surgery,Beijing Jishuitan Hospital,Capital Medical University,Beijing 102100,China;Department of Bone Oncology,Beijing Jishuitan Hospital,Capital Medical University,Beijing 102100,China)

机构地区：[1]首都医科大学附属北京积水潭医院足踝外科,北京100035 [2]首都医科大学附属北京积水潭医院骨肿瘤科,北京100035

出　　处：《中国医药导报》2024年第6期94-97,共4页China Medical Herald

基　　金：北京市医院管理中心青年人才培养“青苗”计划项目(QML20200403)。

摘　　要：目的 分析踝关节骨折切开复位内固定(ORIF)术后感染发生情况及其影响因素。方法 选取2021年2月至2023年1月首都医科大学附属北京积水潭医院收治的踝关节骨折患者179例,根据术后30 d内是否发生感染将患者分为感染组(21例)和非感染组(179例)。比较两组一般资料,采用多因素logistic回归分析确定术后感染的影响因素。结果 179例患者中共21例(11.73%)发生感染,均为手术部位感染(SSI)。感染组糖尿病、开放性骨折、ASA分级Ⅲ级、白细胞计数异常、白蛋白异常的占比高于非感染组,骨折至手术时间长于非感染组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,糖尿病(OR=2.121,95%CI:1.325~3.395)、骨折类型(OR=1.859,95%CI:1.206~2.866)、骨折至手术时间(OR=1.604,95%CI:1.138~2.261)、白蛋白水平(OR=1.455,95%CI:1.078~1.964)是踝关节骨折ORIF术后SSI的影响因素(P<0.05)。结论 伴糖尿病、开放性骨折、ASA分级Ⅲ级及白细胞计数与白蛋白存在异常的踝关节骨折患者ORIF术后更容易发生手术部位感染,临床应重视并积极予以针对性干预。Objective To analyze the incidence and influencing factors of infection after open reduction and internal fixation(ORIF) of ankle fracture.Methods A total of 179 patients with ankle fracture admitted to Beijing Jishuitan Hospital,Capital Medical University from February 2021 to January 2023 were selected.The patients were divided into infected group(21 cases) and non-infected group(179 cases) according to whether infection occurred within 30 days after surgery.The clinical data of the two groups were compared,and the influencing factors of postoperative infection were determined by multivariate logistic regression analysis.Results A total of 21(11.73%) of 179 patients developed infection,all of which were surgical site infection(SSI).The proportion of diabetes mellitus,open fracture,ASA grade Ⅲ,abnormal white blood cell count,and abnormal albumin in infection group was higher than that in non-infection group,and the time from fracture to operation was longer than that in non-infection group,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that diabetes mellitus(OR=2.121,95%CI:1.325-3.395),fracture type(OR=1.859,95%CI:1.206-2.866),fracture to surgery time(OR=1.604,95% CI:1.138-2.261),and albumin level(OR=1.455,95% CI:1.078-1.964) were the factors influencing SSI after ORIF of ankle fracture(P<0.05).Conclusion Ankle fracture patients with diabetes,open fracture,ASA grade Ⅲ and abnormal white blood cell count and albumin are more likely to develop surgical site infection after ORIF surgery,and should be paid attention to and actively targeted intervention.

关 键 词：踝关节骨折 切开复位内固定 手术部位感染 白蛋白 影响因素 

分 类 号：R683.42[医药卫生—骨科学]