经椎间孔腰椎后路融合术治疗腰椎退变性疾病术后切口部位感染的危险因素分析  

Risk factors for surgical site infection after transforaminal lumbar interbody fusion in treatment of lumbar degenerative diseases

作　　者：韩康恩 王洪伟 顾洪闻 胡寅 唐世磊 张智昊 于海龙 HAN Kang-en;WANG Hong-wei;GU Hong-wen;HU Yin;TANG Shi-lei;ZHANG Zhi-hao;YU Hai-long(Graduate School of Dalian Medical University,Dalian Liaoning 116044,China;Department of Orthopedics,General Hospital of Northern TheaterCommand,Shenyang Liaoning 110016,China)

机构地区：[1]大连医科大学研究生院,辽宁大连116044 [2]北部战区总医院骨科,辽宁沈阳110016

出　　处：《局解手术学杂志》2024年第9期810-814,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：辽宁省科技计划联合计划(2023JH2/101700130);辽宁省应用基础研究计划(2022JH2/101300024)。

摘　　要：目的探讨经椎间孔腰椎后路融合术(TLIF)治疗腰椎退变性疾病术后切口部位感染(SSI)的危险因素。方法纳入在我院接受TLIF治疗腰椎退变性疾病的1000例患者,根据手术切口是否发生感染分为感染组(n=23)和非感染组(n=977)。收集患者一般资料、手术及实验室检查指标,采用单因素分析和多因素回归分析筛选SSI的潜在危险因素,建立列线图模型,绘制受试者工作特征(ROC)曲线验证其预测效能。结果TLIF术后患者SSI的发生率为2.3%。单因素分析结果显示,年龄、手术时间、术中出血量、术前C反应蛋白(CRP)、吸烟、糖尿病是SSI发生的重要危险因素;多因素回归分析结果显示,年龄越大、手术时间越长、术中出血量越多、吸烟、患有糖尿病是影响术后SSI发生的独立危险因素。ROC曲线显示,本研究建立的列线图模型具有良好的预测效能。结论年龄较大、手术时间较长、术中出血量较高、吸烟、糖尿病是术后SSI的独立危险因素,针对存在上述高风险因素的患者,术前应采取对应的干预措施,降低SSI的发生率。Objective To explore the risk factors for surgical site infection(SSI)after transforaminal lumbar interbody fusion(TLIF)for the treatment of lumbar degenerative diseases.Methods A total of 1000 patients who underwent TLIF for lumbar degenerative diseases in our hospital were included and divided into the infection group(n=23)and the non-infection group(n=977)according to whether the surgical incision was infected.General data,surgical and laboratory indicators of patients were collected,and potential risk factors of SSI were screened by univariate analysis and multivariate regression analysis,a nomogram model was established,and its predictive efficiency was validated by the receive operating characteristic(ROC)curve.Results The incidence of SSI in patients after TLIF was 2.3%.The results of univariate analysis showed that age,operative time,intraoperative blood loss,preoperative C-reactive protein(CRP),smoking,and diabetes mellitus were the significant risk factors for the occurrence of SSI.Multivariate regression analysis showed that older age,longer operation time,more intraoperative blood loss,smoking and diabetes mellitus were the independent risk factors for postoperative SSI.ROC curve showed that the nomogram model established in this study has good predictive efficiency.Conclusion Older age,longer operation time,more intraoperative blood loss,smoking,and diabetes mellitus were independent risk factors for postoperative SSI.For patients with these high risk factors,corresponding intervention measures should be taken before operation to reduce the incidence of SSI.

关 键 词：经椎间孔腰椎后路融合术 危险因素 切口部位感染 

分 类 号：R687.3[医药卫生—骨科学]