骶管封闭治疗并发感染的危险因素分析
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摘要
目的:分析骶管封闭并发腰椎感染的危险因素,并提出针对性的预防措施。方法:回顾性分析2006年1月至2014年1月行骶管封闭患者210例,通过感染率、单因素分析、感染部位、感染形式及感染菌种的分析,筛选腰椎感染的危险因素。结果:210例患者中并发感染18例,感染率8.6%。感染危险因素分析中,年龄≥40岁、合并糖尿病、合并隐形脊柱裂、穿刺致脑脊液漏和联合4种以上药物注入腰椎患者感染率均高于年龄<40岁、无合并糖尿病、无合并隐形脊柱裂、无穿刺致脑脊液漏和无联合4种以上药物注入者(P<0.05~P<0.01)。感染部位主要发生在腰5至骶1节段及腰后部软组织,感染形式主要为椎间隙感染及腰后部软组织感染,感染的菌种主要为革兰阳性球菌。结论:通过分析骶管封闭引发感染的危险因素,可采取针对性预防措施,规避感染风险。
Objective: To analyze risk factors of lumbar infection caused by sacral canal blocking,and find corresponding preventive measures. Methods: Review cases from Jan. 2006 to Jan. 2014,according to analysis of rate,single factor analysis,sites,types and bacteria species,screen risk factors for lumbar infection. Results: Infection rate was 8. 6%( 18 in 210),among the related risk factors,the cases that over the age of 40,with diabetes mellitus,with spina bifida occulta,with cerebrospinal fluid leakage caused by puncture,and combined with more than 4 kinds of drugs injection,whose infection rates were higher than cases that below the age of 40,without diabetes mellitus,without spina bifida occulta,without cerebrospinal fluid leakage caused by puncture,and combined with less than 4kinds of drugs injection( P < 0. 05 to P < 0. 01). The infection site located mainly in L5~ S1 and posterior lumbar soft tissue,the infection types mainly were intervertebral infection and posterior lumbar soft tissue infection,bacteria species mainly were gram-positive cocci. Conclusions: According to analysis of risk factors of infection caused by sacral canal blocking,we can take preventive measures,to avoid infection.
Objective: To analyze risk factors of lumbar infection caused by sacral canal blocking,and find corresponding preventive measures. Methods: Review cases from Jan. 2006 to Jan. 2014,according to analysis of rate,single factor analysis,sites,types and bacteria species,screen risk factors for lumbar infection. Results: Infection rate was 8. 6%( 18 in 210),among the related risk factors,the cases that over the age of 40,with diabetes mellitus,with spina bifida occulta,with cerebrospinal fluid leakage caused by puncture,and combined with more than 4 kinds of drugs injection,whose infection rates were higher than cases that below the age of 40,without diabetes mellitus,without spina bifida occulta,without cerebrospinal fluid leakage caused by puncture,and combined with less than 4kinds of drugs injection( P < 0. 05 to P < 0. 01). The infection site located mainly in L5~ S1 and posterior lumbar soft tissue,the infection types mainly were intervertebral infection and posterior lumbar soft tissue infection,bacteria species mainly were gram-positive cocci. Conclusions: According to analysis of risk factors of infection caused by sacral canal blocking,we can take preventive measures,to avoid infection.
引文
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[2]刘海涛.老年脊柱术后急性感染诊断及治疗[J].川北医学院学报,2014,29(4):382.
[3]李濂.骨外科手术感染的相关因素分析[J].中国现代医生,2013,51(6):118.
[4]马振江,赵杰,娄伟刚,等.脊柱手术部位感染的危险因素及预防措施研究进展[J].中国脊柱脊髓杂志,2014,24(3):279.
[5]农有弟,陈丽荣,刘晚秋,等.胎儿脊柱裂发生机制及超声诊断临床价值[J].临床和实验医学杂志,2013,12(7):534.
[6]ZARGHOUNI K,ROLLINGHOFF M,SOBOTTKI R,et al.Treatment of spondylodiscitis[J].Int Orthop,2012,36(2):405.
[7]柏春莲,王平.骨科手术部位感染目标性监测结果分析[J].蚌埠医学院学报,2014,39(8):1147.
[8]李若愚,车武,董健.脊柱术后手术部位感染的治疗进展[J].中国脊柱脊髓杂志,2012,22(4):366.