术后伤口感染对后路脊柱内固定患者远期预后的影响

发布时间：2019-03-15 12:21

【摘要】：目的探讨分析后路脊柱内固定患者术后感染对远期预后的影响。方法回顾性分析2006年10月-2014年10月医院行后路脊柱内固定手术1362例患者资料,将术后切口感染73例患者作为感染组,再随机抽取术后无切口感染159例作为未感染组,采用单因素分析以及多因素logistic回归分析比较后路脊柱内固定手术患者术后伤口感染危险因素,术后对患者进行随访,分析伤口感染对患者术后远期伤椎前缘高度、脊柱后凸Cobb角度、椎体成角以及内固定失败率的影响。结果 1362例患者发生术后伤口感染73例,术后伤口感染率为5.36%,其中术后表浅切口感染19例占26.03%、术后深部切口感染54例占73.97%;对73例术后感染患者进行细菌培养,共分离细菌87株,其中革兰阴性菌株18株占20.69%、革兰阳性菌63株占72.41%;术前血糖值及术中出血量为影响患者术后伤口感染的独立危险因素;术后1年、2年,两组伤椎前缘高度与正常椎前缘高度比值、脊柱后凸Cobb角度以及椎体成角差异均具有统计学意义(P0.05);感染组患者术后随访内固定失败率为6.85%显著高于未感染组为1.09%,差异有统计学意义(P0.05)。结论术后伤口感染可明显影响患者术后伤椎的恢复及手术远期预后。
[Abstract]:Objective to investigate the influence of postoperative infection on long-term prognosis of patients with posterior spinal internal fixation. Methods the data of 1362 patients undergoing posterior spinal internal fixation from Oct. 2006 to Oct. 2014 were retrospectively analyzed. 73 patients with postoperative incisional infection were selected as infection group and 159patients with no incision infection were randomly selected as non-infected group. Single factor analysis and multi-factor logistic regression analysis were used to compare the risk factors of postoperative wound infection in patients undergoing posterior spinal internal fixation. The patients were followed up after operation to analyze the long-term height of wound infection on the anterior edge of injured vertebrae after operation. The effect of Cobb angle, vertebral body angle and failure rate of internal fixation on kyphosis. Results there were 73 cases of postoperative wound infection in 1362 patients. The postoperative infection rate was 5.36%. Among them 19 cases were superficial incision infection (26.03%) and 54 cases were deep incision infection (73.97%). A total of 87 strains of bacteria were isolated from 73 patients with postoperative infection, of which 18 were Gram-negative and 63 Gram-positive were 72.41%. Preoperative blood glucose and intraoperative bleeding were independent risk factors for postoperative wound infection. 1 year and 2 years after operation, the ratio of anterior height of injured vertebrae to normal anterior height, the Cobb angle of kyphosis and the angle of vertebral body were significantly different between the two groups (P0.05). The failure rate of internal fixation in infection group (6.85%) was significantly higher than that in non-infection group (1.09%) (P0.05). Conclusion postoperative wound infection can significantly affect the recovery of the injured vertebrae and the long-term prognosis of the operation.
【作者单位】：温岭市第一人民医院骨科;温岭市第一人民医院急诊科;
【基金】：浙江省医药卫生一般研究计划基金资助项目(2015KYB448)
【分类号】：R687.3

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