锁定钢板治疗胫骨骨折术后感染的危险因素分析

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Abstract Objective To explore the related risk factors of postoperative infection of tibial fracture treated by locking plate, and to provide a theoretical basis for the prevention of postoperative infection of tibial fracture treated by locking plate. Methods A total of 416 cases of tibial fracture treated by locking plate internal fixation and followed up in the Orthopaedic Clinical Center of Gansu Hospital of Traditional Chinese Medicine from December 2017 to January 2019 were analyzed retrospectively. The incidence of infection was recorded, and the data of patients were analyzed to explore the causes and prevention methods of infection after the treatment of tibial fracture with locking plate. Results A total of 416 patients were followed up for 6 to 12 months, 45 of them were infected, 56 strains of pathogens were isolated, 34 of which were gram-positive, accounting for 60.71% of the total distribution of pathogens, mainly Staphylococcus aureus and Staphylococcus epidermidis, 22 of which were gram-negative, accounting for 39.29%, mainly Pseudomonas aeruginosa and Escherichia coli. The results of single factor analysis showed that the elderly (χ2=21.025, P ＜ 0.001), body mass index (χ2=6.265, P = 0.012), diabetes mellitus (χ2=65.590, P ＜ 0.001), hypertension (χ2=24.547, P ＜ 0.001), hyperlipidemia (χ2=40.045, P ＜ 0.001), operation time≥140 min (χ2=7.018, P = 0.008), postoperative medication time (χ2=9.502, P = 0.002), hospital stay ≥15 d (χ2=9.890, P = 0.002), intraoperative blood loss (χ2=6.460, P = 0.011), fracture types (χ2=17.104, P ＜ 0.001), invasive operation (χ2=5.657, P = 0.017) were potential risk factors of postoperative infection. Logistic regression analysis showed that BMI≥30 kg/m2(P = 0.006), diabetes mellitus (P ＜ 0.001), hospital stay ≥15 d (P = 0.002), open fracture (P ＜ 0.001), invasive operation (P = 0.020) were independent risk factors for postoperative infection. Conclusion Postoperative infection is related to patients′ own condition, intraoperative condition and postoperative condition. Enough attention should be paid to it during perioperative period, and effective preventive measures should be taken actively, precise treatment plan should be made, individualized treatment should be carried out, and the incidence of postoperative infection should be reduced.

Key words： Locking plate Tibial fracture Internal fixation Infected

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	ZHANG Wenxian1 WANG Bin2 FENG Mingming2 LIAO Minjie1 SU Qi2 LI Jialin2 YAN Qikai2 ZHAO Jian wei2

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ZHANG Wenxian1 WANG Bin2 FENG Mingming2 LIAO Minjie1 SU Qi2 LI Jialin2 YAN Qikai2 ZHAO Jian wei2. Analysis of risk factors of postoperative infection of tibial fracture treated with locking plate[J]. 中国医药导报, 2020, 17(21): 82-87.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I21/82

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