【摘要】：目的:探討手術臺次與腰椎退行性疾病術后切口感染的相關性,為臨床合理安排手術順序提供參考。方法:回顧2014年6月—2016年12月1459例因腰椎退行性疾病在我院行腰椎后路減壓植骨融合內固定術的患者資料,收集術后發(fā)生切口感染的患者作為研究組。同時按1:3的比例,納入同時期接受相同手術治療、術后未發(fā)生并發(fā)癥的患者作為對照組。收集兩組患者的臨床資料,包括性別、年齡、糖尿病病史、手術臺次、術前白細胞、嗜中性粒細胞、嗜中性粒細胞百分比、紅細胞、血紅蛋白、總蛋白、白蛋白及鈣、疾病種類、手術節(jié)段、出血量和輸血量等。對比分析手術臺次與腰椎術后傷口感染的關系。結果:共納入39例腰椎退行性疾病術后傷口感染患者,感染發(fā)生率為2.67%,其中男性22(2.74%)例,女性17(2.60%)例,平均年齡58.77±10.58歲。其中淺表感染27例,深部感染12例。感染組與對照組相比,在性別、年齡、術前白細胞、嗜中性粒細胞、嗜中性粒細胞百分比、紅細胞、血紅蛋白、總蛋白、白蛋白及鈣、疾病診斷、手術節(jié)段及糖尿病病史方面均無統(tǒng)計學差異(P0.05)。logistic回歸分析結果顯示,手術臺次(P=0.001、OR=2.224、95%CI=1.396~3.546)和輸血量(P=0.024、OR=2.811、95%CI=1.146~6.891)是腰椎退行性疾病術后切口感染的獨立危險因素。結論:手術臺次與腰椎退行性疾病術后切口感染密切相關,是切口感染的獨立危險因素之一。術者在安排腰椎手術時,應注意手術順序的安排。
[Abstract]:Objective: to investigate the correlation between operation table and postoperative incision infection of lumbar degenerative disease, and to provide reference for clinical rational arrangement of operation order. Methods: from June 2014 to December 2016, 1459 patients with lumbar degenerative diseases underwent posterior lumbar decompression, bone grafting and internal fixation in our hospital. The patients with postoperative incision infection were collected as the study group. At the same time, according to the 1:3 ratio, the patients who received the same surgical treatment at the same time and had no postoperative complications were taken as the control group. The clinical data of the two groups were collected, including sex, age, history of diabetes, operating table, preoperative leukocyte, percentage of neutrophils, erythrocyte, hemoglobin, total protein, albumin and calcium. Types of diseases, surgical segments, blood loss and blood transfusions, etc. The relationship between operating table times and wound infection after lumbar vertebra operation was compared and analyzed. Results: a total of 39 patients with postoperative wound infection of lumbar degenerative diseases were included. The incidence of infection was 2.67%, including 22 males (2.74%) and 17 females (2.60%), with an average age of 58.77 鹵10.58 years. There were 27 cases of superficial infection and 12 cases of deep infection. The infection group compared with the control group in sex, age, preoperative leukocyte, neutrophil percentage, erythrocyte, hemoglobin, total protein, albumin and calcium, disease diagnosis, The logistic regression analysis showed that the number of operating table (P0. 001) and the volume of blood transfusion (P0. 024) were independent risk factors of incision infection after lumbar degenerative disease operation (P0. 024) and blood transfusion volume (P0. 024 OR2. 811 ~ 95 CII 1.1466.891). The results of logistic regression analysis showed that there was no significant difference in surgical segment and diabetes history (P0.05). The logistic regression analysis showed that the operating table (P0. 001) and the volume of blood transfusion (P0. 024) were independent risk factors for postoperative incision infection. Conclusion: the operating table is closely related to postoperative incision infection of lumbar degenerative disease and is one of the independent risk factors of incision infection. The operator should pay attention to the arrangement of the operation order when arranging the lumbar vertebra operation.
【學位授予單位】：南昌大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3

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