人工种植牙患者围术期感染危险因素分析  

Analysis of risk factors for perioperative infection in patients with dental implants

作　　者：杨琪建 YANG Qijian(Chengdu First People's Hospital,Chengdu O10018,China)

机构地区：[1]成都市中西医结合医院,四川成都610000

出　　处：《中国病原生物学杂志》2025年第3期342-346,共5页Journal of Pathogen Biology

摘　　要：目的探讨人工种植牙患者围术期感染的相关危险因素,以期为临床提供有效预防措施,降低感染发生率。方法回顾性分析本院接诊的85例人工种植牙并发围术期感染患者及同期85例未发生围术期感染的患者的病例资料,对比两组患者在年龄、性别、吸烟史、糖尿病史等方面的差异,进行单因素和多因素Logistic回归分析,筛选出感染的相关危险因素。结果在85例人工种植牙并发围术期感染患者中,共检出病原菌85株。其中,口腔链球菌22株,占25.88%;牙龈卟啉单胞菌19株,占22.35%;中间普雷沃菌17株,占20%;具核梭杆菌9株,占10.59%;福赛斯拟杆菌6株,占7.06%;黑色普雷沃菌5株,占5.88%;韦荣球菌4株,占4.71%;粘性放线杆菌2株,占2.35%;二氧化碳嗜纤维菌1株,占1.18%。口腔链球菌对氨苄西林和哌拉西林的耐药率超过50%,而对头孢吡肟、亚胺培南、环丙沙星、庆大霉素的耐药率低于30%。牙龈卟啉单胞菌对氨苄西林和哌拉西林的耐药率超过50%,对头孢吡肟、亚胺培南、庆大霉素的耐药率低于30%。中间普雷沃菌对氨苄西林、哌拉西林、头孢曲松、美罗培南的耐药率超过50%,对环丙沙星、左氧氟沙星、庆大霉素的耐药率低于30%。对比感染组与对照组患者临床资料,单因素分析显示,年龄、手术时间、合并糖尿病、植入物管理、术后护理依从性、护理护士感染防控意识差异有统计学意义(P<0.05),性别、吸烟史、合并高血压、种植用具及器械卫生、手术室布局、种植体材料差异无统计学意义(P>0.05)。进一步进行多因素分析显示,年龄≥65岁、手术时间≥1.5 h、合并糖尿病、植入物管理不合格、术后护理依从性差、护理护士感染防控意识弱,是人工种植牙患者并发围术期感染的独立危险因素(P<0.05)。结论人工种植牙并发围术期感染患者病原菌主要为口腔链球菌、牙龈卟啉单胞菌等常见菌种,这些病原�Objective To explore the relevant risk factors for perioperative infection in patients with dental implants,in order to provide effective preventive measures for clinical practice and reduce the incidence of infection.MethodsA retrospective analysis was conducted on the case data of 85 patients with dental implants complicated with perioperative infection and 85 patients without perioperative infection during the same period who were admitted to our hospital.The differences in age,gender,smoking history,and diabetes history between the two groups were compared.Univariate and multivariate logistic regression analyses were performed to screen out the relevant risk factors for infection.Results Among 85 patients with dental implants complicated with perioperative infection,a total of 85 strains of pathogenic bacteria were detected.Among them,there were 22 strains of Streptococcus oralis,accounting for 25.88%;19 strains of Porphyromonas gingivalis,accounting for 22.35%;17 strains of Prevotella intermedia,accounting for 20%;9 strains of Fusobacterium nucleatum,accounting for 10.59%;6 strains of Bacteroides forsythus,accounting for 7.06%;5 strains of Prevotella nigrescens,accounting for 5.88%;4 strains of Veillonella,accounting for 4.71%;2 strains of Actinomyces viscosus,accounting for 2.35%;and 1 strain of Capnocytophaga ochracea,accounting for 1.18%.The resistance rate of Streptococcus oralis to ampicillin and piperacillin exceeded 50%,while the resistance rate to cefepime,imipenem,ciprofloxacin and gentamicin was less than 30%.The resistance rate of Porphyromonas gingivalis to ampicillin and piperacillin exceeded 50%,and the resistance rate to cefepime,imipenem and gentamicin was less than 30%.The resistance rate of Prevotella intermedia to ampicillin,piperacillin,ceftriaxone and meropenem exceeded 50%,while the resistance rate to ciprofloxacin,levofloxacin and gentamicin was less than 30%.Comparing the clinical data of patients in the infection group and the control group,univariate analysis showed that there were

关 键 词：人工种植牙 围术期感染 危险因素 

分 类 号：R47[医药卫生—护理学]