后外侧入路腰椎融合手术部位感染的危险因素和干预措施研究  

Risk factors and intervention strategies for surgical site infections in lumbar fusion via posterolateral approach

作　　者：涂丽香 王凤玲[1] 朱晓松 卓凤娟 孙志清[1] 李洪艳 TU lixiang;WANG Fengling;ZHU Xiaosong;ZHUO Fengjuan;SUN Zhiqing;LI Hongyan(Department of Hospital Infection Control,Linyi People’s Hospital,Linyi,Shandong 276003,China)

机构地区：[1]临沂市人民医院医院感染管理部,山东临沂276003

出　　处：《重庆医学》2025年第3期625-629,634,共6页Chongqing Medical Journal

基　　金：国家自然科学基金项目(82003435);国家卫生健康委医院管理研究所“感研”项目(GY2023031-A);山东省自然科学基金项目(ZR2020QH332)。

摘　　要：目的研究后外侧入路腰椎融合手术部位感染的危险因素和干预措施。方法选取2022年1月1日至2023年12月31日该院脊柱外科行后外侧入路腰椎融合术的1078例患者作为研究对象。通过医院感染实时监测系统收集患者相关信息,通过门诊电子病历系统收集患者就诊信息,多因素logistic回归分析相关影响因素。结果1078例患者中,发生感染34例,未发生感染1044例,感染率为3.15%。多因素logistic分析结果显示,年龄、吸烟、合并高血压、合并糖尿病、同期住院时间、手术时间、首次手术术后使用抗菌药物时间、使用抗菌药物时间均是后外侧入路腰椎融合手术部位感染的风险因素(P<0.05)。34例手术部位感染患者中,不同感染部位使用抗菌药物时间比较,差异有统计学意义(P<0.05);腔隙感染患者使用抗菌药物时间最长。结论针对危险因素,加强手术部位感染目标性监测,强化围手术期感染控制措施落实,提高手术相关医院感染管理的科学化、精细化、规范化水平很有必要。Objective To investigate the risk factors and intervention measures for surgical site infection following posterolateral approach lumbar fusion surgery.Methods A total of 1078 patients who underwent posterolateral approach lumbar fusion surgery in the department of spine surgery from January 1,2022 to December 31,2023 were included.Patient related information was collected through the real-time nosocomial infection monitoring system,while medical visit information was obtained via the outpatient electronic medical record system.Multivariate logistic regression analysis was performed to identify risk factors for surgical site infection.Results Among the 1078 patients,34 cases(3.15%)developed surgical site infections,while 1044 cases did not.Multivariate logistic regression analysis revealed that age,smoking,hypertension,diabetes,concurrent hospital stay,operative time,duration of postoperative antimicrobial use after initial surgery,and total antimicrobial use duration were significant risk factors for surgical site infection(P<0.05).Among the 34 infected patients,the duration of antimicrobial use varied significantly across different infection sites(P<0.05),with the longest duration observed in patients with deep space infections.Conclusion Targeted surveillance of surgical site infections should be reinforced based on these risk factors.Perioperative infection control measures must be strictly implemented to improve the scientific,precise,and standardized management of surgical-related nosocomial infections.

关 键 词：腰椎融合术 手术部位感染 LOGISTIC模型 后外侧入路 

分 类 号：R681[医药卫生—骨科学]