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[手术部位感染的重要因素:203例头颈外科手术分析]

[Significant factors for surgical site infection: analysis of 203 head and neck surgeries].

作者信息

Hayama Masaki, Akahani Shiro, Michiba Takahiro, Cho Hironori, Yamamoto Masashi, Mori Terushige

出版信息

Nihon Jibiinkoka Gakkai Kaiho. 2014 Feb;117(2):103-10. doi: 10.3950/jibiinkoka.117.103.

Abstract

Surgical site infection (SSI) is a common complication in head and neck surgeries. The aim of this study was to assess the rate of, and risk factors for SSI following surgical procedures of the head and neck. The study population comprised 206 patients who underwent surgery of head and neck region in NTT West Osaka Hospital between 2009 and 2011. The incidence rate and risk factors were estimated by the chi-square test and a logistic regression analysis. SSI occurred in 22 cases (10.8%) of 203 patients. A broad range of putative risk factors was recorded in each patient and statistically analyzed to elucidate SSI related factors. Univariate analysis indicated that low BMI, diabetes mellitus, anemia, hypoalbuminemia, surgical wound classification, duration of operation, blood loss, left implants and preoperative radiotherapy were risk factors associated with SSI. Multivariate statistics revealed four independent risk factors: surgical wound classification (odds ratio (OR) 5.88, p = 0.02), hypoalbuminemia (OR 11.48, p < 0.01), duration of operation (OR 18.66, p < 0.01) and left implants (OR 20.24, p < 0.01). Thus, to achieve a reduction in SSI, we need to take care of not only the factors related with surgical technique such as the duration of the operation or left implants, but the preoperative nutrition status.

摘要

手术部位感染(SSI)是头颈外科手术中常见的并发症。本研究旨在评估头颈外科手术后SSI的发生率及危险因素。研究对象为2009年至2011年期间在西日本电信电话公司大阪医院接受头颈区域手术的206例患者。通过卡方检验和逻辑回归分析估计发生率和危险因素。203例患者中有22例(10.8%)发生了SSI。记录了每位患者的一系列可能的危险因素,并进行统计学分析以阐明与SSI相关的因素。单因素分析表明,低体重指数、糖尿病、贫血、低白蛋白血症、手术伤口分类、手术时间、失血量、植入物留存和术前放疗是与SSI相关的危险因素。多因素统计显示四个独立危险因素:手术伤口分类(比值比(OR)5.88,p = 0.02)、低白蛋白血症(OR 11.48,p < 0.01)、手术时间(OR 18.66,p < 0.01)和植入物留存(OR 20.24,p < 0.01)。因此,为了降低SSI的发生率,我们不仅需要关注与手术技术相关的因素,如手术时间或植入物留存,还需要关注术前营养状况。

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