Pilon骨折术后感染的危险因素分析

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摘要目的分析Pilon骨折术后感染的相关危险因素。方法收集自2005年1月至2019年12月共621例Pilon骨折患者，全部采用切开复位钢板内固定术治疗。按照术后是否感染分为两组，其中感染组39例，男26例，女13例；年龄20～72岁，平均(43.4±13.5)岁。非感染组582例，男303例，女279例；年龄19~71岁，平均(42.1±12.0)岁。年龄、性别、身体质量指数(body mass index，BMI)、吸烟、糖尿病、高血压、饮酒、软组织损伤情况、手术时间、输血、引流时间等纳入可能的危险因素作为研究对象，统计学方法先采用单变量分析，有显著意义的危险因素再采用多变量的Logistic回归分析。结果 Pilon骨折手术部位感染率为6.28%，单变量分析发现感染组与非感染组之间的糖尿病患者、手术时间以及软组织损伤情况差异有统计学意义，而多变量的Logistic回归分析却发现仅手术时间与手术部位感染显著相关(P＜0.01，OR=0.121)。结论手术时间是Pilon骨折切开复位钢板内固定术后手术部位感染的独立预测指标，而严重软组织损伤虽能增加手术部位感染率，却不是Pilon骨折切开复位钢板接骨术后手术部位感染的独立预测指标。

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关键词 ： Pilon骨折, 术后感染, 危险因素

Abstract：Objective To analyze the risk factors of surgical site infection in Pilon fracture.Methods From January 2005 to December 2019，621 patients with Pilon fracture were treated with open reduction and internal fixation.According to the surgical site infection，the patients were divided into two groups：infection group (n＝39)，including male (n＝26) and female (n＝13)，with an average age of (43.4±13.5)years(range from 20 to 72 years)，and non-infection group (n＝582)，including 303 males and 279 females，with an average age of (42.1±12.0)years(range from 19 to 71 years).Age，sex，smoking，BMI，diabetes，alcohol consumption，hypertension，soft tissue injury，operation time，blood transfusion，and drainage time were included in the possible risk factors.The statistical method was univariate analysis first，and then multivariate Logistic regression analysis was used to analyze the significant risk factors.Results The rate of surgical site infection of Pilon fracture was 6.28%.Univariate analysis showed that there were significant differences in diabetes，operation time and soft tissue injury between infection group and non-infection group，while multivariate Logistic regression analysis found that only operation time was significantly correlated with operation site infection (P＜0.01).Conclusion Operation time is an independent predictor of surgical site infection after open reduction and internal fixation of Pilon fracture.Although severe soft tissue injury can increase the infection rate of surgical site，it is not an independent predictor of surgical site infection after open reduction and plate internal fixation of Pilon fracture.

Key words： Pilon fracture surgical site infection risk factors

基金资助:山东省自然科学基金(ZR2020MH088)

通讯作者: 卢舜

作者简介: 李庆虎(1985－ )，男，医师，山东第一医科大学附属省立医院，250021。

引用本文:

李庆虎，傅佰圣，赵闯，王永会，周东生，毕丛丛，卢舜 *. Pilon骨折术后感染的危险因素分析[J]. 实用骨科杂志, 2021, 27(7): 598-606.
Li Qinghu，Fu Baisheng，Zhao Chuang，et al. Risk Factors of SurgicalSite Infection in Pilon Fracture. sygkzz, 2021, 27(7): 598-606.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2021/V27/I7/598

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