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筋膜切开术后急性前臂间隔综合征患者的手术部位感染:危险因素的回顾性分析。

Surgical site infection following fasciotomy in patients with acute forearm compartment syndrome: a retrospective analysis of risk factors.

机构信息

Department of Orthopedics, The First Central Hospital of Baoding, Baoding, 071000, China.

Department of Nephrology, The First Central Hospital of Baoding, Baoding, 071000, China.

出版信息

Eur J Trauma Emerg Surg. 2023 Oct;49(5):2129-2137. doi: 10.1007/s00068-023-02294-w. Epub 2023 Jun 6.

Abstract

PURPOSE

Fasciotomy, a standard therapy for acute forearm compartment syndrome (AFCS), can prevent serious complications, but there may be significant postoperative consequences. Surgical site infection (SSI) may cause fever, discomfort, and potentially fatal sepsis. This study aimed to identify risk factors for SSI in AFCS patients who had undergone fasciotomy.

MATERIALS AND METHODS

Patients with AFCS who had fasciotomies between November 2013 and January 2021 were recruited. We collected demographic information, comorbidities, and admission laboratory results. Analyses of continuous data were conducted using the t-test, the Mann-Whitney U test, and logistic regression analysis, while analyses of categorical data were conducted using the Chi-square and Fisher's exact tests.

RESULTS

Sixteen AFCS patients (13.9%) suffered infections that need further therapy. Using the logistic regression analysis, we identified that patients with a history of diabetes (p = 0.028, OR = 16.353, 95% CI (1.357, 197.001)), open fractures (p = 0.026, OR = 5.239, 95% CI (1.223, 22.438)), and a higher level of TC (p = 0.004, OR = 4.871, 95% CI (1.654-14.350)) were the best predictors of SSI, while ALB levels (p = 0.004, OR = 0.776, 95% CI (0.653-0.924)) were protective for SSI in AFCS patients.

CONCLUSIONS

Our results showed that open fractures, diabetes, and TC levels were relevent risk factors for SSI following fasciotomy in patients with AFCS, allowing us to personalize the risk assessment and apply early targeted interventions.

摘要

目的

筋膜切开术是急性前臂间隔综合征(AFCS)的标准治疗方法,可预防严重并发症,但可能会有显著的术后后果。手术部位感染(SSI)可能导致发热、不适,并潜在致命的败血症。本研究旨在确定接受筋膜切开术的 AFCS 患者发生 SSI 的危险因素。

材料与方法

纳入 2013 年 11 月至 2021 年 1 月间接受 AFCS 筋膜切开术的患者。收集人口统计学信息、合并症和入院实验室结果。连续数据的分析采用 t 检验、Mann-Whitney U 检验和逻辑回归分析,分类数据的分析采用卡方检验和 Fisher 精确检验。

结果

16 例 AFCS 患者(13.9%)发生需要进一步治疗的感染。采用逻辑回归分析,我们发现患有糖尿病的患者(p=0.028,OR=16.353,95%CI(1.357,197.001))、开放性骨折(p=0.026,OR=5.239,95%CI(1.223,22.438))和较高的 TC 水平(p=0.004,OR=4.871,95%CI(1.654-14.350))是 SSI 的最佳预测因素,而 ALB 水平(p=0.004,OR=0.776,95%CI(0.653-0.924))是 AFCS 患者 SSI 的保护因素。

结论

我们的结果表明,开放性骨折、糖尿病和 TC 水平是 AFCS 患者筋膜切开术后 SSI 的相关危险因素,使我们能够进行个体化的风险评估并应用早期针对性干预。

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