初次腰椎后路内固定早期切口感染的相关因素

Related factors of early surgical site infection after primary posterior lumbar interbody fusion

摘要:

[目的] 探讨初次腰椎后路内固定术后早期切口感染的相关因素。[方法] 纳入我院2019年1月-2022年1月行腰椎后路内固定术患者468例，根据术后是否发生早期切口感染分为2组，单因素分析2组患者一般资料，以是否发生早期切口感染为因变量，单因素分析差异因素为自变量进行多元逻辑回归分析。[结果] 468例患者中有18例发生早期切口感染。感染组患者女性比例、年龄、术前合并糖尿病及尿路感染、手术时间、术后引流量及引流时间高于未感染组；而感染组患者术前白蛋白及血红蛋白低于未感染组，差异均有统计学意义（P＜0.05）。两组患者在体质指数、是否吸烟、是否合并高血压及慢性肺病、ASA分级和术中失血量等指标差异无统计学意义（P＞0.05）。多因素逻辑回归分析显示，术前合并糖尿病（OR=1.898，P=0.011）/尿路感染（OR=1.612，P=0.027）、引流时间的延长（OR=1.426，P=0.015）是术后早期切口感染的危险因素；而男性（OR=0.811，P=0.038）和白蛋白水平（OR=0.676，P=0.002）是减少切口感染的保护因素。[结论]女性、术前合并糖尿病/尿路感染、低蛋白血症及引流时间延长是腰椎后路内固定术后早期切口感染危险因素。

Abstract:

[Objective] To explore the related factors of early surgical site infection (SSI) after primary posterior lumbar interbody fusion (PLIF). [methods] A total of 468 patients received PLIF in our hospital from January 2019 to January 2022 were enrolled. According to the occurrence of early SSI, the patients were divided into two groups, and the general data were analyzed by univariate analysis. Multivariate logistic regression analysis was conducted with the dichotomous variable of whether early SSI occurred and difference factors in univariate analysis as independent variables to identify the related factors of early SSI . [Results] Among 468 patients with PLIF, 18 patients developed early SSI. The proportion of female patients, age, preoperative diabetes and urinary tract infection, operation time, postoperative drainage volume and drainage time in the SSI group were higher than those in the non-SSI group. The preoperative albumin and hemoglobin in the SSI group were lower than those in the non-SSI group, and the differences were statistically significant (P < 0.05). There were no significant differences in body mass index, smoking status, hypertension and chronic lung disease, ASA classification, and intraoperative blood loss between the two groups (P > 0.05). Logistic regression analysis showed that preoperative diabetes mellitus (OR=1.898，P=0.011)/urinary tract infection (OR=1.612，P=0.027), prolonged drainage time (OR=1.426，P=0.015) were risk factors for early SSI. Men (OR=0.811，P=0.038) and albumin level (OR=0.676，P=0.002) were protective factors in reducing early SSI. [Conclusion] Women, preoperative diabetes/urinary tract infection, hypoproteinemia and prolonged drainage time are risk factors for early SSI after PLIF.