[1]王飞 周崇斌 梁伟 胡真△.切开复位内固定治疗踝关节骨折术后感染的相关因素分析及检测[J].中国中医骨伤科杂志,2019,27(07):41-44.
　WANG Fei ZHOU Chongbin LIANG Wei HU Zhen.Relevant Factors of Infection after Open Reduction and Internal Fixation for Ankle Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2019,27(07):41-44.
点击复制

切开复位内固定治疗踝关节骨折术后感染的相关因素分析及检测()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第27卷
期数:
2019年07期
页码:
41-44
栏目:
临床论著
出版日期:
2019-06-30

文章信息/Info

Title:
Relevant Factors of Infection after Open Reduction and Internal Fixation for Ankle Fracture
文章编号:
1005-0205(2019)07-0041-04
作者:
王飞1 周崇斌1 梁伟1 胡真2△
1浙江丽水市人民医院骨科(浙江 丽水,323000) 2浙江丽水市人民医院司法鉴定所
Author(s):
WANG Fei1 ZHOU Chongbin1 LIANG Wei1 HU Zhen2△
1Orthopaedics Department,Lishui People's Hospital,Lishui 323000,Zhejiang China; 2Judicial Identification Office,Lishui People's Hospital,Lishui 323000,Zhejiang China.
关键词:
切开复位内固定;  踝关节骨折;  手术部位感染;  相关因素
Keywords:
open reduction and internal fixation;  ankle fracture;  surgical site infection;  related factors
分类号:
R683.42
文献标志码:
A
摘要:
目的:探讨影响切开复位内固定治疗踝关节骨折术后感染的相关因素。方法:选取2015年3月至2018年7月本院就诊的238例踝关节骨折患者为研究对象,观察患者治疗前后VAS评分变化情况,对患者进行为期6个月的随访,观察患者治疗后感染发生情况。采用单因素及多因素Logistic回归分析影响踝关节骨折患者术后感染的相关因素,采用受试者工作特征曲线分析联合检测踝关节患者术后感染的价值。结果:踝关节骨折患者治疗后VAS评分明显降低(P<0.05),238例患者中11例(4.62%)发生手术部位感染。单因素及多因素Logistic回归分析显示,年龄、BMI、吸烟、损伤类型、切口清洁程度、手术时间、NEUT及ALB与踝关节骨折患者术后手术部位感染密切相关。联合检测诊断术后手术部位感染的AUC为0.916.结论:切开复位内固定治疗踝关节骨折术后感染与高龄、高BMI、吸烟、手术时间长、切口清洁度差、高NEUT及ALB等相关,此类患者应警惕手术部位感染的发生。
Abstract:
To explore the related factors of infection after open reduction and internal fixation for ankle fracture.Methods:238 patients with ankle fracture were selected from March 2015 to July 2018.The VAS score was observed before and after treatment.Patients were followed up for six months to observe the incidence of infection after treatment.Univariate and multivariate logistic regression analysis was used to analyze the related factors affecting postoperative infection in patients with ankle fracture.Value of combined detection of post-operative infection in ankle patients was analyzed by receiver operating characteristic curve(ROC)analysis.Results: After treatment,the VAS score of ankle fracture patients decreased significantly(P<0.05).Of 238 patients,11(4.62%)had surgical site infection.Univariate and multivariate logistic regression analysis showed that age,BMI,smoke,injury type,incision cleanliness,operation time,NEUT,ALB were closely related to the infection of surgical site in patients with ankle fracture after treatment.AUC of combined detection for diagnosis of surgical site infection after operation was 0.916.Conclusion:Postoperative infection after open reduction and internal fixation for ankle fracture is associated with age,high BMI,smoking,long operation time,poor incision cleanliness and high NEUT,ALB,etc.Such patients should be alert to the occurrence of surgical site infection.

参考文献/References:

[1] 李永恒,洪茂,张岩峰,等.中医骨伤科对踝关节扭伤的认识及治疗方法[J].中国中医骨伤科杂志,2017,25(3):70-71.
[2] 高武长,王英振.切开复位内固定踝关节骨折:联合带线锚钉修复三角韧带损伤的意义[J].中国组织工程研究,2016,20(9):1255-1260.
[3] DORR M C,BACKES M,LUITSE J S,et al.Complications of kirschner wire use in open reduction and internal fixation of calcaneal fractures[J].J Foot Ankle Surg,2016,55(5):915-917.
[4] 陈京峰,仝晓明,李治斌.补阳还五汤加减配合切开复位内固定术治疗旋后外旋型踝关节骨折的疗效观察[J].中华中医药学刊,2016,34(4):1021-1024.
[5] SUN Y,WANG H,TANG Y,et al.Incidence and risk factors for surgical site infection after open reduction and internal fixation of ankle fracture[J].Medicine,2018,97(7):e9901.
[6] 陆宸照.踝关节损伤的诊断和治疗[M].上海:上海科学技术文献出版社,1998.
[7] 严广斌.视觉模拟评分法[J].中华关节外科杂志:电子版,2014,8(2):34-36.
[8] 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,2003,81(5):314-320.
[9] LEIMER E M,PAPPAN K L,NETTLES D L,et al.Lipid profile of human synovial fluid following intra-articular ankle fracture[J].J Orthop Res,2017,35(3):657-666.
[10] 张鹏,董启榕,王宗允,等.内、外侧双切口结合Herbert螺钉内固定治疗合并同侧踝关节骨折的Hawkins Ⅲ型距骨颈骨折[J].中华医学杂志,2016,96(41):3342-3346.
[11] 鲜文峰.经皮微创闭合复位与切开复位内固定治疗踝关节骨折的临床疗效比较探讨[J].中国实用医药,2016,11(23):66-67.
[12] 姜矞恒,李莹,王岩.踝关节骨折畸形愈合的诊断与治疗研究进展[J].中华创伤骨科杂志,2017,19(3):268-271.
[13] 蔡三,高丽萍,杨李军,等.血流变学指标及血清学指标在骨折延迟愈合患者中的临床意义[J].现代生物医学进展,2017,17(18):3517-3519.
[14] 牟哲飞,倪跃平,叶秀云,等.不同体重指数与骨折患者手术部位感染的关系[J].中华医院感染学杂志,2013,23(17):4178-4180.

备注/Memo

备注/Memo:
(收稿日期:2019-03-04)△通信作者 E-mail:151946828@qq.com
更新日期/Last Update: 2019-06-30