[1]段小静,韩超,陈洪.骨科I类（清洁）切口早期感染相关危险因素的前瞻性研究[J].中华老年骨科与康复电子杂志,2020,(04):197-203.[doi:10.3877/cma.j.issn.2096-0263.2020.04.003]
　Duan Xiaojing,Han Chao,Chen Hong..Prospective study of risk factors analysis about orthopaedic sterile incision with early infection[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2020,(04):197-203.[doi:10.3877/cma.j.issn.2096-0263.2020.04.003]
点击复制

骨科I类（清洁）切口早期感染相关危险因素的前瞻性研究()
分享到：

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2020年04期
页码:
197-203
栏目:
骨与创伤
出版日期:
2020-08-05

文章信息/Info

Title:
Prospective study of risk factors analysis about orthopaedic sterile incision with early infection
作者:
段小静1; 韩超2; 陈洪3
053000 衡水，河北省衡水市人民医院血液透析室1，影像中心2，关节运动医学科3
Author(s):
Duan Xiaojing1;  Han Chao2;  Chen Hong3.
1Department of Hemodialysis Room, 2Department of CT Room, 3Department of Joint Sports Medicine, Hengshui people’s Hospital, Hengshui 053000, China
关键词:
前瞻性研究;  骨科;  切口感染;  危险因素
Keywords:
Prospective study;  Orthopedic;  Surgical site infection;  Risk factor
DOI:
10.3877/cma.j.issn.2096-0263.2020.04.003
文献标志码:
A
摘要:
目的 研究骨科I类切口出现术后早期切口感染的相关危险因素。方法 前瞻性收集河北省衡水市人民医院骨科中心2020年1月1日至6月30日间收治的I类切口骨科手术患者且符合纳入排除标准的患者779例，随访观察其术后早期感染发生情况，对可能影响术后切口感染的27个指标[患者因素：年龄、性别、职业、城市或农村、BMI、吸烟史、过敏史、手术史、术前合并症、致伤原因；手术相关因素：受伤至手术时间、麻醉时间、麻醉方式、术中有创操作（桡动脉测压）、手术持续时间、术中出血量、术中输血量、术中晶体输入量、术中胶体输入量、术中体温、ASA分级；术前实验室检查：血常规、肝肾功能、血凝分析]进行单因素筛选和logistic回归分析，筛选出骨科术后早期切口感染的独立危险因素。结果 本研究共759例患者获得完整随访，随访率97.4%。随访时间（6.7±0.9）d，其中男420例，女339例，平均年龄（41±22）岁。随访期间共24例患者出现手术切口感染，其中浅感染22例，深感染2例，感染率为3.16%，且以金黄色葡萄球菌感染为主（55.6%）。单因素分析中两组患者的麻醉方式、白细胞、中性粒细胞计数、血清白蛋白差异有统计学意义（P＜0.05），logistic回归分析得出术前低血清白蛋白（P＜0.05）为术后早期切口感染的独立危险因素，骨科无菌切口早期感染概率[P=11+e-(7.882-0.119ALB)]。血清白蛋白≤35 g/L时，感染率高达23.43%。结论 骨科患者术前低血清白蛋白是I类手术切早期感染独立危险因素，术前提高患者血清白蛋白有利于预防切口早期感染。
Abstract:
Objective To prospectively study postoperative early infection of orthopaedic sterile incision so as to identify risk factors. Methods To investigate and follow up the incidence of early postoperative infection in patients with type I incision admitted to the Orthopedic Center of our hospital from January 1 to June 30, 2020. The 27 indicators that may affect postoperative incision infection were age, gender, occupation, urban or rural area, BMI, smoking history, allergic history, operation history, preoperative complications, and cause of injury The time from injury to operation, anesthesia time, anesthesia method, invasive operation (radial artery manometry), operation duration, intraoperative blood loss, intraoperative blood transfusion, intraoperative lens input, intraoperative colloid input, intraoperative body temperature, preoperative antibiotics, ASA classification; preoperative laboratory examination: routine blood test, liver and kidney function, hemagglutination analysis, univariate screening and logistic regression were performed Objective to analyze and screen the independent risk factors of early postoperative incision infection. Results A total of 759 patients were followed up, the follow-up rate was 97.4%. There were 420 males and 339 females with an average age of (41±22) years. During the follow-up period, 24 patients had surgical incision infection, the infection rate was 3.16%, and Staphylococcus aureus infection was the main infection (55.6%). In univariate analysis, there were significant differences in anesthesia mode, white blood cell (WBC), neutrophil count (neut) and serum albumin (ALB) between the two groups (P<0.05). Logistic regression model analysis indicated that preoperative ALB (P<0.05) were independent risk factors for early postoperative infection of incisional Wound，The probability of infection in orthopedic sterile early incision[P=11+e-(7.882-0.119ALB)]. ALB≤35 g/L, the infection rate as high as 23.43%. Conclusion Highlighting preoperative ALB levels in patients has an important role in improving the prevention of early infection in orthopedic sterile incision.

相似文献/References:

[1]陈旭光,张天燕,单新１,等.围术期抑郁对老年骨科手术患者单核细胞组织因子表达及血小板功能的影响[J].中华老年骨科与康复电子杂志,2016,(03):155.[doi:10.3877//cma.j.issn2096-2063.2016.03.006]
　Chen Xuguang,Zhang Tianyan,Shan Xin,et al.Effect of depressive disorder on tissue factor expression of monocytes and platelet function in elderly patients undergoing orthopaedic surgery[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(04):155.[doi:10.3877//cma.j.issn2096-2063.2016.03.006]
[2]李航,刘强,陈建平,等.右美托咪定在老年椎管内麻醉中对麻黄碱升压作用的影响[J].中华老年骨科与康复电子杂志,2016,(04):234.[doi:10.3877/cma.j.issn.2096-0263.2016.04.008]
　Li Hang,Liu Qiang,et al.Effects of dexmedetomidine on pressor response to ephedrine in elderly patients undergoing intravertebral anesthesia[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(04):234.[doi:10.3877/cma.j.issn.2096-0263.2016.04.008]
[3]李亚南,张琦,霍树平,等.不同麻醉方式联合静脉快通道在老年下肢微创骨科手术中的应用研究[J].中华老年骨科与康复电子杂志,2017,(04):232.[doi:10.3877/cma.j.issn.2096-0263.2017.04.007]
　Li Yanan,Zhang Qi,Huo Shuping,et al.Comparison of different anesthesia methods combined with fast track anesthesia for elderly patients undergoing orthopedic minimally invasive lower limbs surgeries[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(04):232.[doi:10.3877/cma.j.issn.2096-0263.2017.04.007]
[4]杨雄刚,胡永成,赵立明.老年骨科患者血栓预防的研究现状[J].中华老年骨科与康复电子杂志,2018,(02):65.[doi:10.3877/cma.j.issn.2096-0263.2018.02.001]
　Yang Xionggang,Hu Yongcheng,Zhao Liming.The thromboprophylaxis in geriatric orthopedics patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(04):65.[doi:10.3877/cma.j.issn.2096-0263.2018.02.001]
[5]刘烨,解雅英.老年骨科患者术后镇痛研究现状及新进展[J].中华老年骨科与康复电子杂志,2019,(01):58.[doi:10.3877/cma.j.issn.2096-0263.2019.01.011]
　Liu Ye,Xie Yaying.Research status and new progress of postoperative analgesia in elderly orthopedic patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(04):58.[doi:10.3877/cma.j.issn.2096-0263.2019.01.011]
[6]李莉,张丽天,申雅文,等.复合护理干预预防骨科术后深静脉血栓的临床研究[J].中华老年骨科与康复电子杂志,2022,(03):177.[doi:10.3877/cma.j.issn.2096-0263.2022.03.009]
　Li Li,Zhang Litian,Shen Yawen,et al.Clinical study on combined nursing intervention in prevention of deep vein thrombosis after orthopedics surgery[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2022,(04):177.[doi:10.3877/cma.j.issn.2096-0263.2022.03.009]

更新日期/Last Update: 2020-08-18