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1.大连医科大学研究生院,辽宁 大连 116044
2.北部战区总医院骨科,辽宁 沈阳 110016
于海龙,E-mail:yuhailong118@aliyun.com
纸质出版日期:2024-09-25,
收稿日期:2024-03-30,
移动端阅览
韩康恩,王洪伟,顾洪闻等.经椎间孔腰椎后路融合术治疗腰椎退变性疾病术后切口部位感染的危险因素分析[J].局解手术学杂志,2024,33(09):810-814.
HAN Kang-en,WANG Hong-wei,GU Hong-wen,et al.Risk factors for surgical site infection after transforaminal lumbar interbody fusion in treatment of lumbar degenerative diseases[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(09):810-814.
韩康恩,王洪伟,顾洪闻等.经椎间孔腰椎后路融合术治疗腰椎退变性疾病术后切口部位感染的危险因素分析[J].局解手术学杂志,2024,33(09):810-814. DOI: 10.11659/jjssx.03E024171.
HAN Kang-en,WANG Hong-wei,GU Hong-wen,et al.Risk factors for surgical site infection after transforaminal lumbar interbody fusion in treatment of lumbar degenerative diseases[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(09):810-814. DOI: 10.11659/jjssx.03E024171.
目的
2
探讨经椎间孔腰椎后路融合术(TLIF)治疗腰椎退变性疾病术后切口部位感染(SSI)的危险因素。
方法
2
纳入在我院接受TLIF治疗腰椎退变性疾病的1 000例患者,根据手术切口是否发生感染分为感染组(
n
=23)和非感染组(
n
=977)。收集患者一般资料、手术及实验室检查指标,采用单因素分析和多因素回归分析筛选SSI的潜在危
险因素,建立列线图模型,绘制受试者工作特征(
ROC
)曲线验证其预测效能。
结果
2
TLIF术后患者SSI的发生率为2.3%。单因素分析结果显示,年龄、手术时间、术中出血量、术前C反应蛋白(CRP)、吸烟、糖尿病是SSI发生的重要危险因素;多因素回归分析结果显示,年龄越大、手术时间越长、术中出血量越多、吸烟、患有糖尿病是影响术后SSI发生的独立危险因素。
ROC
曲线显示,本研究建立的列线图模型具有良好的预测效能。
结论
2
年龄较大、手术时间较长、术中出血量较高、吸烟、糖尿病是术后SSI的独立危险因素,针对存在上述高风险因素的患者,术前应采取对应的干预措施,降低SSI的发生率。
Objective
2
To explore the risk factors for surgical site infection (SSI) after transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar degenerative diseases.
Methods
2
A total of 1 000 patients who underwent TLIF for lumbar degenerative diseases in our hospital were included and divided into the infection group (
n
=23) and the non-infection group (
n
=977) according to whether the surgical incision was infected.General data,surgical and laboratory indicators of patients were collected,and potential risk factors of SSI were screened by univariate analysis and multivariate regression analysis,a nomogram model was established
and its predictive efficiency was validated by the
receive operating characteristic
(
ROC
) curve.
Results
2
The incidence of SSI in patients after TLIF was 2.3%.The results of univariate analysis showed that age,operative time,intraoperative blood loss,preoperative C-reactive protein (CRP),smoking,and diabetes mellitus were the significant risk factors for the occurrence of SSI.Multivariate regression analysis showed that older age,longer operation time,more intraoperative blood loss,smoking and diabetes mellitus were the independent risk factors for postoperative SSI.
ROC
curve showed that the nomogram model established in this study has good predictive efficiency.
Conclusion
2
Older age,longer operation time,more intraoperative blood loss,smoking,and diabetes mellitus were independent risk factors for postoperative SSI.For patients with these high risk factors,corresponding intervention measures should be taken before operation to reduce the incidence of SSI.
经椎间孔腰椎后路融合术危险因素切口部位感染
transforaminal lumbar interbody fusionrisk factorssurgical site infection
王滕羽,罗科宇,刘瑶瑶,等.Wiltse入路联合TLIF治疗腰椎滑脱症的中远期疗效[J].局解手术学杂志,2022,31(7):595-599.doi:10.11659/jjssx.03E022096http://dx.doi.org/10.11659/jjssx.03E022096.
Sato T,Shibahashi K,Aoki M,et al.Risk factors for surgical site infection following orthopaedic surgery for fracture by trauma:a nested case-control study[J].J Hosp Infect,2024,145:52-58.doi:10.1016/j.jhin.2023.08.028http://dx.doi.org/10.1016/j.jhin.2023.08.028.
Tan T,Lee H,Huang MS,et al.Prophylactic postoperative measures to minimize surgical site infections in spine surgery:systematic review and evidence summary[J].Spine J,2020,20(3):435-447.doi:10.1016/j.spinee.2019.09.013http://dx.doi.org/10.1016/j.spinee.2019.09.013.
Zhou J,Wang R,Huo X,et al.Incidence of surgical site infection after spine surgery:a systematic review and meta-analysis[J].Spine (Phila Pa 1976),2020,45(3):208-216.doi:10.1097/brs.00000000 00003218http://dx.doi.org/10.1097/brs.0000000000003218.
中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.doi:10.3760/j:issn:0376-2491. 2001.05.027http://dx.doi.org/10.3760/j:issn:0376-2491.2001.05.027.
安燕,王慧,赵晓勇,等.腰椎术后手术部位感染的危险因素分析及列线图模型建立[J].临床麻醉学杂志,2023,39(5):461-466.doi:10.12089/jca.2023.05.002http://dx.doi.org/10.12089/jca.2023.05.002.
Kuo CC,Hess RM,Soliman MAR,et al.Predicting prolonged length of stay in patients undergoing transforaminal lumbar interbody fusion[J].Acta Neurochir (Wien),2022,164(10):2655-2665.doi:10.1007/s00701-022-05334-3http://dx.doi.org/10.1007/s00701-022-05334-3.
Bischoff P,Kramer TS,Schröder C,et al.Age as a risk factor for surgical site infections:German surveillance data on total hip replacement and total knee replacement procedures 2009 to 2018[J].Euro Surveill,2023,28(9):2200535.doi:10.2807/1560-7917.ES.2023.28.9. 2200535http://dx.doi.org/10.2807/1560-7917.ES.2023.28.9.2200535.
Kang HJ,Kwon YM,Byeon SJ,et al.Trends and risk factors for surgical site infection after treatment of the ankle fracture:national cohort study[J].J Clin Med,2023,12(13):4215.doi:10.3390/jcm 12134215http://dx.doi.org/10.3390/jcm12134215.
Blair MJ,Jones JD,Woessner AE,et al.Skin structure-function relationships and the wound healing response to intrinsic aging [J].Adv Wound Care (New Rochelle),2020,9(3):127-143.doi:10.1089/wound.2019.1021http://dx.doi.org/10.1089/wound.2019.1021.
刘列华,罗磊,李培,等.腰椎经椎弓根动态固定术后感染的临床特征及治疗策略[J].中华骨科杂志,2021,41(17):1275-1282.doi:10.3760/cma.j.cn121113-20210316-00244http://dx.doi.org/10.3760/cma.j.cn121113-20210316-00244.
Pitzer CR,Aboaziza EA,O'Reilly JM,et al.Nicotine and microvascular responses in skeletal muscle from acute exposure to cigarettes and vaping[J].Int J Mol Sci,2023,24(12):10208.doi:10.3390/ijms241210208http://dx.doi.org/10.3390/ijms241210208.
Martin CT,Gao Y,Duchman KR,et al.The impact of current smoking and smoking cessation on short-term morbidity risk after lumbar spine surgery[J].Spine (Phila Pa 1976),2016,41(7):577-584.doi:10.1097/brs.0000000000001281http://dx.doi.org/10.1097/brs.0000000000001281.
Anis HK,Sodhi N,Klika AK,et al.Is operative time a predictor for post-operative infection in primary total knee arthroplasty?[J].J Arthroplasty,2019,34(7s):S331-S336.doi:10.1016/j.arth.2018. 11.022http://dx.doi.org/10.1016/j.arth.2018.11.022.
Birgand G,Saliou P,Lucet JC.Influence of staff behavior on infectious risk in operating rooms:what is the evidence?[J].Infect Control Hosp Epidemiol,2015,36(1):93-106.doi:10.1017/ice.2014.9http://dx.doi.org/10.1017/ice.2014.9.
Tominaga H,Setoguchi T,Ishidou Y,et al.Risk factors for surgical site infection and urinary tract infection after spine surgery [J].Eur Spine J,2016,25(12):3908-3915.doi:10.1007/s00586-016-4674-2http://dx.doi.org/10.1007/s00586-016-4674-2.
Anderson PA,Savage JW,Vaccaro AR,et al.Prevention of surgical site infection in spine surgery[J].Neurosurgery,2017,80(3s):S114-S123.doi:10.1093/neuros/nyw066http://dx.doi.org/10.1093/neuros/nyw066.
房照,张阳,张立志,等.高龄腰椎退行性疾病患者后路减压融合手术的疗效及并发症[J].中国脊柱脊髓杂志,2020,30(5):399-404.doi:10.3969/j.issn.1004-406X.2020.05.03http://dx.doi.org/10.3969/j.issn.1004-406X.2020.05.03.
Hsiung W,Yao YC,Lin HH,et al.Reducing surgical site infections after spine surgery:the optimal amount of normal saline for intra-wound irrigation[J].Spine J,2023,23(11):1580-1585.doi:10.1016/j.spinee.2023.07.011http://dx.doi.org/10.1016/j.spinee.2023.07.011.
Xiao B,Chen TY,Zhao Q,et al.Risk factors for surgical site infection after percutaneous endoscopic lumbar discectomy[J].Int Wound J,2024,21(4):e14605.doi:10.1111/iwj.14605http://dx.doi.org/10.1111/iwj.14605.
Canseco JA,Chang M,Karamian BA,et al.Postoperative glycemic variability as a predictor of adverse outcomes following lumbar fusion[J].Spine (Phila Pa 1976),2022,47(7):E304-E311.doi:10.1097/brs.0000000000004214http://dx.doi.org/10.1097/brs.0000000000004214.
Bhattacharya S,Munshi C.Biological significance of C-reactive protein,the ancient acute phase functionary[J].Front Immunol,2023,14:1238411.doi:10.3389/fimmu.2023.1238411http://dx.doi.org/10.3389/fimmu.2023.1238411.
Lasocki S,Krauspe R,von Heymann C,et al.PREPARE:the prevalence of perioperative anaemia and need for patient blood management in elective orthopaedic surgery:a multicentre,observational study[J].Eur J Anaesthesiol,2015,32(3):160-167.doi:10.1097/eja.0000000000000202http://dx.doi.org/10.1097/eja.0000000000000202.
Nakanishi K,Kanda M,Kodera Y.Long-lasting discussion:adverse effects of intraoperative blood loss and allogeneic transfusion on prognosis of patients with gastric cancer[J].World J Gastroenterol,2019,25(22):2743-2751.doi:10.3748/wjg.v25.i22.2743http://dx.doi.org/10.3748/wjg.v25.i22.2743.
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