中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (31): 4955-4958.doi: 10.3969/j.issn.2095-4344.0337

• 脊柱植入物 spinal implant • 上一篇    下一篇

手术顺序是否为腰椎手术后切口感染的危险因素

刘云涛1,吐尔洪江·阿布都热西提1,王 艺1,马 良1,朱松青1,金格勒2   

  1. 1新疆医科大学第六附属医院微创脊柱外科,新疆维吾尔自治区乌鲁木齐市 830002;2新疆医科大学第一附属医院,新疆维吾尔自治区乌鲁木齐市 830054
  • 出版日期:2018-11-08 发布日期:2018-11-08
  • 通讯作者: 金格勒,新疆医科大学第一附属医院,新疆维吾尔自治区乌鲁木齐市 830054
  • 作者简介:刘云涛,男,硕士,主治医师,主要从事骨组织工程方面的研究。

Whether surgical sequence is a risk factor for incision infection after lumbar surgery  

Liu Yun-tao1, Tuerhongjiang·Abudurexiti1, Wang Yi1, Ma Liang1, Zhu Song-qing1, Jin Ge-le2   

  1. 1Department of Minimally Invasive Spine Surgery, the Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830002, Xinjiang Uygur Autonomous Region, China; 2the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Online:2018-11-08 Published:2018-11-08
  • Contact: Jin Ge-le, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • About author:Liu Yun-tao, Master, Attending physician, Department of Minimally Invasive Spine Surgery, the Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830002, Xinjiang Uygur Autonomous Region, China

摘要:

文章快速阅读:

 
 

 

文题释义:
术后伤口感染:是脊柱手术后最常见的并发症,相关文献中报道的发病率为0.5%-20%。为了优化院内感染的预防策略,并为患者提供必要的指导,必须详细了解感染发生相关危险因素。
手术顺序对术后切口感染的影响:大多数外科伤口感染的来源是手术室中的污染物或患者的皮肤菌群。手术空气中微生物的数量与手术室人员的数量、活动范围以及手术人员的消毒技术成正比;而靠后的手术往往会出现麻醉医师及器械护士的交接班使得手术室人员流动增加从而增加感染风险。手术顺序较靠前的手术环境中的微生物较少,而手术顺序靠后的手术空气中微生物含量不断增加,这使得术后感染的风险也逐渐增加。
 
摘要
背景:腰椎手术比颈椎术后感染的风险更高,到目前为止,很少有文献研究手术顺序和术后感染风险之间的关系。
目的:探讨手术顺序是否是患者术后切口感染的危险因素。
方法:回顾性分析行后路手术的778例腰椎间盘突出症及腰椎管狭窄症患者的病历资料,将患者年龄、性别、手术顺序、手术时间长短、术中出血量、输血、内固定使用、Cage使用、手术节段数作为术后切口感染的可能影响因素进行单因素分析,采用Logistic回归分析确定危险因素。
结果与结论:①778例腰椎间盘突出症及腰椎管狭窄症患者术后感染率为4.2%(33/778),其中浅表手术切口感染23例,深部切口感染10例;②手术的顺序(P=0.020,OR=3.050,95%CI=1.196-7.780)、年龄(P=0.019,OR=2.123,95%CI=1.133-3.979)、手术时长(P=0.034,OR=3.035,95%CI=1.089-8.457)与术中出血量(P=0.024,OR=2.059,95%CI=1.099-3.860),均为术后切口感染的危险因素;③切口长度(P=0.106,OR=1.805,95%CI=0.881-3.969)与术中输血(P=0.107,OR=2.171,95%CI=0.846-5.570)、手术节段(P=0.206,OR=0.578,95%CI=0.223-1.499)则对术后感染影响不显著;④通过研究发现,行后路手术的腰椎间盘突出症及腰椎管狭窄症患者术后切口感染的危险因素除了年龄、手术时长、术中出血量之外,手术的顺序也是一个重要的危险因素。

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
ORCID: 0000-0002-2914-9517(刘云涛)

关键词: 手术的顺序, 术后切口感染, 危险因素, 腰椎间盘突出症, 腰椎管狭窄症, 年龄, 手术时长, 术中出血量, 输血, 内固定, 回顾性分析

Abstract:

BACKGROUND: Incidence of postoperative infection in lumbar surgery is higher than that in cervical surgery. However, there are few studies on the relationship between surgical sequence and incision infection.

OBJECTIVE: To investigate whether surgical sequence is a risk factor for postoperative incision infection.
METHODS: Clinical data of 778 patients with lumbar disc herniation and lumbar spinal stenosis undergoing posterior surgical treatment were analyzed retrospectively. Age, sex, surgical sequence, operation time, blood loss, blood transfusion, internal fixator usage, Cage usage and surgical segment were used for single-factor analysis, and risk factors were confirmed by Logistic regression analysis.
RESULTS AND CONCLUSION: (1) In this study, 778 lumbar disc herniation and lumbar spinal stenosis patients had a 4.2% incidence of infection (33/778), including 23 cases of superficial wound infection and 10 cases of deep wound infection. (2) The surgical sequence (P=0.020, OR=3.050, 95%CI=1.196-7.780), age (P=0.019, OR=2.123, 95%CI=1.133-3.979), operation time (P=0.034, OR=3.035, 95%CI=1.089-8.457) and blood loss (P=0.024, OR=2.059, 95%CI=1.099-3.860), were the risk factors for postoperative infection. (3) The incision length (P=0.106, OR=1.805, 95%CI=0.881-3.969), intraoperative blood transfusion (P=0.107, OR=2.171, 95%CI=0.846-5.570), and surgical segment (P=0.206, OR=0.578, 95%CI=0.223-1.499) had no significant effect on postoperative infection. (4) In summary, for lumbar disc herniation and lumbar spinal stenosis patients except age, operation time, and intraoperative blood loss, surgical sequence is a critical risk factor for incision infection after posterior approach surgery in patients with lumbar disc herniation and lumbar spinal stenosis.

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

Key words: Lumbar Vertebrae, Spinal Stenosis, Factor Analysis, Statistical, Internal Fixators, Tissue Engineering

中图分类号: