后路腰椎融合内固定术后感染的危险因素分析 |
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引用本文: | 桑朝辉,任海龙,孟湛东,江建明.后路腰椎融合内固定术后感染的危险因素分析[J].南方医科大学学报,2018,38(8):969. |
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作者姓名: | 桑朝辉 任海龙 孟湛东 江建明 |
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摘 要: | 目的探讨初次后正中入路腰椎椎管减压椎间植骨融合内固定术后手术部位感染的危险因素。方法回顾性收集2011年
至2016年因腰椎退行性疾病初次行后路腰椎减压椎间植骨融合内固定手术的患者共2904例,使用随机数法抽取其中术后未发
生感染的患者为对照组(334例),术后30 d内发生感染的患者为实验组(43例),收集患者的身高、体质量、性别、年龄、基础疾病、
手术节段、手术时长、术中失血量、术后引流量、皮下脂肪厚度及多裂肌脂肪浸润率等一般资料。使用Logistic回归分析探讨各
个因素与术后感染的关系。结果Logistic回归分析中,女性(P=0.016)、多节段手术(P=0.001)、皮下脂肪厚度(P=0.000)及多裂
肌脂肪浸润(P=0.000)为术后手术部位感染的危险因素。其中多裂肌脂肪浸润与体质量指数(BMI)无相关性(P>0.05)。结论
女性、多节段手术、皮下脂肪厚度和多裂肌脂肪浸润为初次后正中入路腰椎减压椎间植骨融合内固定术后手术部位感染的危险
因素。多裂肌脂肪浸润为独立于BMI腰椎特有的术后感染危险因素。
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Risk factors for surgical site infection following posterior lumbar intervertebral fusion |
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Abstract: | Objective To analyze the risk factors of surgical site infection (SSI) following posterior lumbar intervertebral fusion.
Methods This retrospective case-control study was conducted in 2904 patients undergoing posterior lumbar intervertebral
fusion from 2011 to 2016. Forty-three patients with SSI within 30 days after the operation served as the case group, and 334
randomly selected patients without infection served as the control group. Age, gender, diabetes, body mass index (BMI),
albumin level, multilevel procedures, subcutaneous fat thickness, surgery duration and the percentage of lumbar multifidus
muscle fat infiltration were analyzed, and univariate and multivariate logistic regression analyses were performed to identify
the risk factors of SSI. Results Multivariate logical regression analysis identified a female gender, subcutaneous fat thickness,
multilevel surgery, and lumbar multifidus muscle fat infiltration as significant risk factors for SSI (P<0.05). BMI was not
correlated with fat infiltration in the lumbar multifidus muscle (P>0.05). Conclusion A female gender, multilevel surgery,
subcutaneous fat thickness and fat infiltration in the multifidus muscle are related to SSI following posterior lumbar
intervertebral fusion. Fat infiltration in the multifidus muscle was a spine-specific risk factor for SSI independent of BMI. |
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