魏萌, 柳洪宙, 王磊. 布鲁氏杆菌性脊柱炎术后伤口不愈合的危险因素分析[J]. 解放军医学院学报, 2021, 42(10): 1020-1024. DOI: 10.3969/j.issn.2095-5227.2021.10.003
引用本文: 魏萌, 柳洪宙, 王磊. 布鲁氏杆菌性脊柱炎术后伤口不愈合的危险因素分析[J]. 解放军医学院学报, 2021, 42(10): 1020-1024. DOI: 10.3969/j.issn.2095-5227.2021.10.003
WEI Meng, LIU Hongzhou, WANG Lei. Factors associated with non-healing wounds after brucellosis spondylitis[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2021, 42(10): 1020-1024. DOI: 10.3969/j.issn.2095-5227.2021.10.003
Citation: WEI Meng, LIU Hongzhou, WANG Lei. Factors associated with non-healing wounds after brucellosis spondylitis[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2021, 42(10): 1020-1024. DOI: 10.3969/j.issn.2095-5227.2021.10.003

布鲁氏杆菌性脊柱炎术后伤口不愈合的危险因素分析

Factors associated with non-healing wounds after brucellosis spondylitis

  • 摘要:
      背景  布鲁氏杆菌性脊柱炎作为布鲁氏杆菌引起的一种传染性变态反应性疾病,其治疗方式主要为手术治疗和保守药物治疗。布鲁氏杆菌性脊柱炎患者手术切口为非清洁切口,术后易发生伤口不愈合 。目的 本研究通过分析布鲁氏菌性脊柱炎患者术后伤口不愈合的危险因素,为预防该类患者术后伤口不愈合提供参考。
      方法  该研究纳入2013年1月- 2018年1月于邯郸市中心医院行手术治疗的布鲁氏菌性脊柱炎患者94例。记录患者的基本资料及围术期相关指标。应用多因素logistic回归分析布鲁氏杆菌性脊柱炎患者术后伤口不愈合的危险因素。
      结果  94例患者中男54例,女40例,年龄(47.36±7.32)岁。13例(13.83%)出现术后伤口不愈合。年龄(OR:1.135,95% CI:1.032 ~ 1.248,P=0.009)、合并糖尿病(OR:9.020,95% CI:1.294 ~ 62.885,P=0.026)、手术病灶清除程度(OR:20.911,95% CI:1.908 ~ 229.141,P=0.013)和血白蛋白水平(OR:0.776,95% CI:0.664 ~ 0.907,P=0.001)是布鲁氏杆菌性脊柱炎患者术后伤口不愈合的危险因素。
      结论  高龄、合并糖尿病、手术病灶清除不彻底及血白蛋白水平降低是布鲁氏杆菌性脊柱炎患者术后伤口不愈合的危险因素。合理选择手术适应证是降低术后伤口不愈合发生率的关键。

     

    Abstract:
      Background  Brucella spondylitis is an infectious allergic disease caused by Brucella. Its treatment methods are mainly divided into surgical treatment for debridement and conservative drug treatment. For the surgical incisions of patients with Brucella spondylitis are non-clean incisions, the wound will not heal after surgery.
      Objective  To analyze the factors associated with postoperative non-healing wound in patients with brucellosis spondylitis, and provide evidence to reduce the incidence of postoperative non-healing wound in this disease.
      Methods  Totally 94 patients with Brucella spondylitis who underwent surgical treatment in our hospital from January 2013 to January 2018 were enrolled in this study. The patients' basic information and perioperative information were recorded. Multivariate logistic regression analysis was used to analyze the risk factors of wound non-healing in patients with Brucella spondylitis.
      Results  Of the 94 cases (54 males and 40 females, average age of 47.36±7.32 years old), wound non-healing was found in 13 patients (13.83%). Age (OR: 1.135, 95% CI: 1.032-1.248, P=0.009), combined diabetes (OR: 9.020, 95% CI: 1.294-62.885, P=0.026), extent of resection of involved site (OR: 20.911, 95% CI: 1.908-229.141, P=0.013) and blood albumin level (OR: 0.776, 95% CI: 0.664-0.907, P=0.001) were risk factors of postoperative non-healing wound in patients with Brucella spondylitis.
      Conclusion  Elderly patients, combined diabetes, incomplete resection of involved site and decreased blood albumin levels are risk factors for postoperative wound non-healing of Brucella spondylitis. Reasonable choice of surgical indications is the key to reduce incidence of wound non-healing after operation.

     

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