口腔颌面部手术部位感染11年趋势分析

目的了解口腔颌面部手术部位感染(SSI)例次发病率的变化趋势,探索患者ASA评分、手术切口类型、手术持续时间及手术危险指数等因素对SSI发病率的影响。方法对2007—2017年在某三级口腔专科医院住院并接受口腔颌面部手术患者的数据进行回顾性分析,采用趋势卡方检验分析SSI例次发病率变化趋势,采用二元logistic回归分析其发生风险。结果 2007—2017年口腔颌面部手术患者SSI例次发病率为0.33%～0.93%,平均发病率为0.71%;ASA评分、手术切口类型、手术持续时间及手术危险指数高的患者,SSI例次发病率及发生风险高;2009年SSI例次发病率最低,ASA评分为P1的手术患者、手术危险指数为1级的手术,SSI例次发病率下降,分别自2011年的0.72%和2.79%下降至2017年的0.42%和1.54%,下降幅度在41%以上。结论口腔颌面部SSI例次发病率在11年间有所下降并保持在较低水平,随着患者ASA评分、手术切口类型、手术持续时间及手术危险指数的升高,手术患者SSI例次发病率及发生风险亦逐渐升高,诊疗环境可能是SSI的影响因素之一。

Trend of incidence of surgical site infection following oral and maxillofacial surgery during 11 years

Objective To understand the changing trend of incidence of surgical site infection (SSI) following oral and maxillofacial surgery, and explore the influence of American Society of Anesthesiologists(ASA) score, type of incision, duration of operation and surgical risk index. Methods Data of patients who were hospitalized and underwent oral and maxillofacial surgery in a tertiary dental hospital from 2007 to 2017 were retrospectively analyzed. Trend Chi-square test was used to analyze the changing trend of incidence of SSI, binary logistic regression was used to analyze the risk of SSI. Results From 2007 to 2017, incidence of SSI in patients with oral and maxillofacial surgery was 0.33%-0.93%, with an average of 0.71%; patients with high indexes of ASA score, type of incision, duration of operation and surgical risk had higher incidence and risk of SSI; incidence of SSI was the lowest in 2009. In patients with ASA score of P1, surgical risk index of grade 1, incidence of SSI declined from 0.72% and 2.79% in 2011 to 0.42% and 1.54% in 2017 respectively, with a decrease of more than 41%. Conclusion Incidence of SSI following oral and maxillofacial surgery decreased and finally remained at a low level during 11 years, with the increase of ASA score, risk indexes score of surgical incision type, duration of surgery and surgical risk, incidence and risk of SSI increased gradually, medical environment may be one of the factors that affected SSI.