Abstract:Objective To approach risk factors of postoperative infection for spinal posterior. Methods From March 2014 to March 2016, in Second People's Hospital of Neijiang City, the clinical data of 1170 spinal posterior postoperative infection patients were selected, they were divided into two groups by infection or not, infection group 300 cases and no infection group 870 cases. The preoperative risk factors, intraoperative factors, postoperative factors and infection rate of two groups were observed, the multi-factors of postoperative infection for spinal posterior were observed. Results The myodynamia≤3 grade, immunologic decline, acute or chronic infection, operation time≥180 min, amount of bleeding>600 mL, allograft, no correct using antibiotics, gatism or retention catheterization before operation, after operation ≥3 d, shift in to ICU after operation, number of drainage tube, indwelling drainage tube>5 d of infection group were lower than no infection group, the differences were statistical significance (P < 0.05 or P < 0.01). The acute or chronic infection, BMI>30 kg/m2, shift in to ICU after operation were risk factors of postoperative infection for spinal posterior (P < 0.05). Conclusion The acute or chronic infection, BMI>30 kg/m2, shift to ICU after operation are risk factors of postoperative infection for spinal posterior.
[1] 陈路,孙廓,廖琦,等.VSD闭式冲洗引流技术在治疗脊柱后路内固定术后感染中的应用[J].江西医药,2015,50(6):517-518.
[2] Schwarzkopf R,Chung C,Park JJ,et al. Effects of perioperative blood product use on surgical site infection following thoracic and lumbar spinal surgery [J]. Spine(Phila Pa 1976),2010,35(3):340-346.
[3] 薛镜,宋跃明,李涛,等.闭式冲洗引流治疗脊柱后路内固定术后早期感染[J].四川医学,2015,36(4):437.
[4] Watanabe MD,Sakai D,Matsuyama,et al. Risk factors for surgical site infection following spine surgery:efficacy of intraoperative saline irrigation [J]. Neurosurg Spine,2010, 12(5):540-546.
[5] 钟沃权,曾岩,齐强,等.脊柱后路内固定术后迟发性感染的治疗[J].中国脊柱脊髓杂志,2015,25(11):977-983.
[6] Rao SB,Vasquez G,Harrop J,et al. Risk factors for surgical site infections following spinal fusion procedures: a case-control study [J]. Clin Infect Dis,2011,53(7):686-692.
[7] 刘志安,戈才华,方虎,等.脊柱后路内固定术后早期伤口感染危险因素分析及治疗方法的研究[J].中华医院感染学杂志,2013,23(19):4704-4706.
[8] Koutsoumbelis S,Hughes AP,Girardi FP,et al. Risk factors for postoperative infection following posterior lumbar instru-mented arthrodesis [J]. J Bone Joint Surg Am,2011, 93(17):1627-1633.
[9] 中华医学会糖尿病学分会.中国2型糖尿病防治指南2013年版[J].中华糖尿病杂志,2014,6(7):447-498.
[10] 中国医学科学院心血管病研究所高血压组.两种高血压诊断标准的评价[J].中国医学科学院学报,1979,1(2):139-143.
[11] Westby MD. Rehabilitation and total joint arthroplasty [J]. Clin Geriatr Med,2012,28(2):489-508.
[12] Gunne AFPT,Mohamed AS,Skolasky RL,et al. The presentation,incidence,etiology,and treatment of surgical site infections after spinal surgery [J]. Spine,2010,35(13):1323-1328.
[13] 袁浩,曹广如,蔡玉强,等.脊柱后路术后深部感染应用持续闭式冲洗引流术对炎性应激状态的影响研究[J].中华医院感染学杂志,2016,26(18):4161-4163.
[14] Liu C,Bayer A,Cosgrove SE,et al. Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin -resistant staphylococcus aureus infections in adults and children [J]. Clin Infect Dis,2011, 52(1):e18-e55.
[15] 宋庆华,尚晖.伤口持续闭式冲洗术治疗早期脊柱后路内固定术后切口感染[J].中国骨与关节损伤杂志,2014, 29(7):708-709.
[16] Shen J,Liang J,Yu H,et al. Risk factors for delayed infections after spinal fusion and instrumentation in patients with scoliosis [J]. J Neurosurg Spine,2014,21(4):648-652.
[17] 郑海波.腹部手术切口感染危脸因素及病原菌调查[J].中华医院感染学杂志,2011,21(2):270-271.
[18] Maruo K,Berven SH. Outcome and treatment of postoperative spine surgical site infections:predictors of treatment success and failure [J]. J Orthop Sci,2014,19(3):398-404.
[19] 孙明举,高赛明,王艳辉,等.闭合式负压吸引技术治疗脊柱内固定术后深部创口感染[J].中国脊柱脊髓杂志,2012,22(7):665-666.
[20] Albert F,David B. Incidence,prevalence,and analysis of risk factors for surgical site infection following adult spinal surgery [J]. Spine,2009,34(13):1422-1428.
[21] Sampedro MF,Huddleston PM,Piper KE,et al. A biofilm approach to detect bacteria on removed spinal implants [J]. Spine,2010,35(12):1218-1224.
[22] 庄泽民,丁真奇.脊柱后路内固定术后深部感染的研究进展[J].医学综述,2015,21(19):3534-3537.
[23] Manish K,Kasliwal,Lee A,et al. Infection with spinal instrumentation:Review of pathogenesis,diagnosis,prevention,and management [J]. Surg Neurol Int,2013,4(Suppl 5):392-403.