脊柱外科术后感染的影响因素分析

目的分析脊柱外科手术后发生感染的独立危险因素。方法分析脊柱外科接受手术治疗的病例资料,40例术后30 d内发生感染的患者作为病例组,同时匹配同期40例未发生感染的患者作为对照组。收集可能影响术后感染的相关因素,采用单因素条件多因素条件Logistic回归分析对纳入的单因素进行逐步筛选,之后采用多因素条件Logistic回归分析进一步明确可造成脊柱外科术后感染的独立危险因素。结果单因素Logistic回归分析初步筛选出术后感染与年龄、营养状况、糖尿病、既往手术史、手术范围、术后转入ICU和预防性抗生素使用不当因素相关性较高(P0.05)。进一步采用多因素Logistic回归分析发现营养状况、糖尿病、术后转入ICU和预防性抗生素使用不当是影响脊柱外科术后感染的独立危险因素。结论营养状况、糖尿病、术后转入ICU和预防性抗生素使用不当是导致脊柱外科术后感染的独立危险因素,临床上应密切关注,以防感染。

Risk factors analysis of patients with postoperative infection after spine surgery

Objective To explore the independent risk factor of patients with postoperative infection after spine sur-gery. Methods Forty patients with postoperative infection ( occurred in 30 d after spine surgery) were selected and medical history were retrospective viewed as case group, as well as 40 patients without infection were chosen as con-trol group. Related factors of postoperative infection were collected and used single factor conditional Logistic regres-sion to screen the related factors gradually, and then multiple conditional Logistic regression analysis was hired to fur-ther clarify independent risk factors which can cause postoperative infection after spinal surgery. Results Single fac-tor Logistic regression analysis showed that the correlation between age, nutrition, diabetes, history of surgery, scope of operation, transfer to ICU postoperatively, prophylactic antibiotics misuse and postoperative infection was high( P<0. 05). Further Logistic regression analysis found that nutrition, diabetes, and transferred to the ICU postopera-tively and prophylactic antibiotics misuse were independent risk factors to affect the postoperative infection of spine surgery. Conclusions Nutrition, diabetes, and transferred to the ICU postoperatively and prophylactic antibiotics misuse are independent risk factors to affect the postoperative infection of spine surgery. All of them should be watched carefully during treatment to avoid infections.