Pilon骨折手术部位感染的危险因素分析

目的：探讨Pilon骨折手术部位感染的相关危险因素.方法：从创伤骨科资料室收集自2006年1月至2012年12月共561例采用切开复位钢板接骨术治疗的Pilon骨折,感染组33例,男23例,女10例,年龄21～69岁,平均（45.50±4.40）岁;非感染组528例,男296例,女232例,年龄16～76岁,平均（43.50±7.19）岁.年龄、性别、吸烟、糖尿病、饮酒、开放性骨折、骨筋膜室综合征及手术时间纳入可能的危险因素作为研究对象,统计学方法先采用单变量分析,有显著意义的危险因素再采用多变量的Logistic回归分析.结果：Pilon骨折手术部位感染率为5.88％,单变量分析发现感染组与非感染组之间的手术时间、开放性骨折以及骨筋膜室综合征差异有统计学意义,而多变量的Logistic回归分析却发现仅手术时间与手术部位感染显著相关（P=0.005,OR=44.92）.结论：手术时间是Pilon骨折切开复位钢板接骨术后手术部位感染的独立预测指标,而开放性骨折和骨筋膜综合征虽能增加手术部位感染率,却不是Pilon骨折切开复位钢板接骨术后手术部位感染的独立预测指标.

Analyzing risk factors for surgical site infection following Pilon fracture surgery

Objective: To study the related risk factors for surgical site infection following Pilon fracture surgery.Methods: The data of 561 patients with Pilon fractures treated with open reduction plate osteosynthesis at our institution's trauma centre were collected from January 2006 to December 2012. All the patients were divided into two groups:infection group and non-infection group. In the infection group,there were 23 males and 10 females,ranging in age from 21 to 69 years old,with an average of (45.50±4.40) years old. In the non-infection group,there were 296 males and 232 females,ranging in age from 16 to 76 years old,with an average of(43.50±7.19) years old. The possible risk factors such as age,gender,smoking,diabetes,alcohol abuse,open fractures,compartment syndrome and operative time were studied. The multivariate Logistic regression model was used to analyze the risk factors.Results: The infection rate of surgical site after Pilon fracture surgery was 5.88%. There were significant statistical differences between infection group and non-infection group in operative time,open fractures and compartment syndrome. However,multivariate Logistic regression analysis revealed that only operative time was significantly associated with surgical site infection (P=0.005,OR=44.92).Conclusion: Operation time is an independent predictor for postoperative surgical site infection of Pilon fracture treated with open reduction plate osteosynthesis. Though open fracture and compartment syndrome could increase the surgical site infection rate,they could not not be considered as independent predictors.