| 复杂胫骨平台骨折术后感染危险因素分析 |
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Received:July 12, 2016
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| 作者 | Author | 单位 | Unit | E-Mail |
| 马炬雷 |
MA Ju-lei |
安徽医科大学解放军九八临床学院, 浙江 湖州 313000
中国人民解放军第九八医院骨四科, 浙江 湖州 313000 |
The Fourth Department of Orthopaedics, the 98th Hospital of PLA, Huzhou 313000, Zhejiang, China |
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| 徐云钦 |
XU Yun-qin |
中国人民解放军第九八医院骨四科, 浙江 湖州 313000 |
The Fourth Department of Orthopaedics, the 98th Hospital of PLA, Huzhou 313000, Zhejiang, China |
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| 申屠刚 |
SHEN Tu-gang |
中国人民解放军第九八医院骨四科, 浙江 湖州 313000 |
The Fourth Department of Orthopaedics, the 98th Hospital of PLA, Huzhou 313000, Zhejiang, China |
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| 李强 |
LI Qiang |
中国人民解放军第九八医院骨四科, 浙江 湖州 313000 |
The Fourth Department of Orthopaedics, the 98th Hospital of PLA, Huzhou 313000, Zhejiang, China |
DHSpirit@yeah.net |
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| 期刊信息：《中国骨伤》2017年30卷，第10期，第896-900页 |
| DOI：10.3969/j.issn.1003-0034.2017.10.004 |
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目的：分析复杂胫骨平台骨折术后感染的危险因素。
方法：对 2010年9月至2015年3月采用切开复位内固定手术治疗的293例复杂胫骨平台骨折患者的临床资料进行回顾性分析，男199例，女94例；年龄17～80岁，平均47.3岁。 将患者的性别、年龄、是否吸烟、有无糖尿病、骨折类型（开放/闭合）、开放性骨折分型（Gustilo-Anderson分型）、闭合性骨折软组织损伤分级（Tscherne-Gotzen分级）、骨折分型（SchatzkerⅤ型/Ⅵ型）、是否有骨筋膜室综合征、ASA分级、麻醉方法、手术时机（急诊/择期）、手术时间（≤150 min/>150 min）、手术切口入路、是否联合入路、内固定部位等纳入可能的危险因素作为研究对象，采用 Logistic分析其相关性。
结果：293例患者中，术后发生感染12例，感染率为4.10%.单因素分析结果显示，骨折类型（χ2=14.496，P=0.001），骨折分型（χ2=4.560，P=0.033），骨筋膜室综合征（χ2=15.631，P=0.001），手术时间（χ2=11.233，P=0.001）是复杂胫骨平台骨折术后感染的相关因素。多因素分析结果显示，开放骨折（χ2=9.696，P=0.002），骨筋膜室综合征（χ2=9.119，P=0.003）是复杂胫骨平台骨折术后感染的危险因素。
结论：开放骨折、骨筋膜室综合征是复杂胫骨平台骨折术后感染的危险因素，对开放骨折患者进行彻底清创，对骨筋膜室综合征早期诊断和及时处理，降低感染的发生率。 |
| [关键词]:胫骨 骨折 感染 危险因素 |
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| Analysis of risk factors of infection for complex tibial plateau fractures after operation |
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Abstract:
Objective:To analyze the risk factor of infection for complex tibial plateau fractures after operation.
Methods:Totally clinical data of 293 patients with complex tibial plateau fractures underwent open reduction and internal fixation were retrospectively analyzed from September 2010 to March 2015,including 199 males and 94 females,ranging in age from 17 to 80 years old with an average of 47.3 years old. The possible risk factors such as gender,age,smoking,diabetes,type of fracture(open/closed),classification of open fracture(Gustilo-Anderson classification),classification of soft tissue injury in closed fracture (Tscherne-Gotzen classification),fracture classification(SchatzkerⅤ/Ⅵ),osteofascial compartment syndrome,ASA score,anesthesia,timing of surgery,operative time(≤150 min/>150 min),surgical approach,combined approach or not,internal fixation site were studied. The multivariate Logistic regression model was used to analyze the risk factors.
Results:Twelve patients were infected of all 293 patients after operation,the infection rate was 4.10%. Univariate analysis showed that fracture type(χ2=14.496,P=0.001),fracture classification(χ2=4.560,P=0.033),osteofascial compartment syndrome(χ2=15.631,P=0.001),operative time(χ2=11.233,P=0.001) were correlated with complex tibial plateau fractures postoperative infection. Multivariate analysis showed that open fractures(χ2=9.696,P=0.002) and osteofascial compartment syndrome(χ2=9.119,P=0.003) were complex tibial plateau fracture risk factors for infection after operation.
Conclusion:Open fractures and osteofascial compartment syndrome are risk factor of complex tibial plateau fracture for infection after operation. While through debridement for open fracture patients,early diagnosis and promt treatment for osteofascial compartment syndrome could reduce incidence of infection. |
| KEYWORDS:Tibia Fractures Infection Risk factors |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 马炬雷,徐云钦,申屠刚,李强.复杂胫骨平台骨折术后感染危险因素分析[J].中国骨伤,2017,30(10):896~900 |
| 英文格式: | MA Ju-lei,XU Yun-qin,SHEN Tu-gang,LI Qiang.Analysis of risk factors of infection for complex tibial plateau fractures after operation[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(10):896~900 |
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