庆大霉素胶原海绵减少术后手术部位感染的临床应用

摘要

Objective To explore clinical application of gentamicin-impregnated collagen sponge for reducing surgical site infection after spinal surgery. Methods Clinical data of 232 patients undergoing spinal surgery from March 2012 to March 2015 in Ankang Hospital of Traditional Chinese Medicine were collected and analyzed in this retrospective study,of all patients,110 cases(group A) were treated with gentamicin-impregnated collagen sponge,and 122 cases(group B) didn't use it. Statistical methods(Pearson chi-square test or Fisher exact test) were used to determine the risk factors of surgical site infection,including gentamicin-impregnated collagen sponge,age,gender,diabetes mellitus,smoking,operative region,surgical grade,operation duration,and surgical implantation. Results Ten patients(4.3%) suffered surgical site infection,including 3 S. epidermidis infection,3 methicillin-resistant staphylococcus aureus(MRSA) infection,2 E.faecium infection and 2 no pathogen detected. In the 10 infected patients,one received gentamicin-impregnated collagen sponge in spinal surgery and the remaining 9 had no use of gentamicin-impregnated collagen sponge. There was a correlation between gentamicin-impregnated collagen sponge use and surgical site infection,and other factors(age,sex,diabetes mellitus,smoking,operative region,surgical grade,operation duration,surgical implantation) showed no statistical correlation with surgical site infection(P>0.05). The incidence of surgical site infection in patients who used gentamicin-impregnated collagen sponge(0.9%,1/110) was lower than that in patients who did not use it(7.4%,9/122)(P<0.05),while age,sex,diabetes mellitus,smoking,operative region,surgical grade,operation duration,and surgical implantation in patients with or without use of gentamicin-impregnated collagen sponge in spinal surgery showed no significant difference(P>0.05). No adverse effects from using gentamicin-impregnated collagen sponge were observed. Conclusion Using gentamicin-impregnated collagen sponge could decrease surgical site infection rate and contribute to recovery.%目的 探讨庆大霉素胶原海绵在脊柱手术术后减少手术部位感染的临床应用.方法 回顾性分析2012年3月—2015年3月在安康市中医院骨科行脊柱手术的232例患者的临床资料,其中110例(A组)使用了庆大霉素胶原海绵,122例(B组)未使用.采用Pearsonχ2检验或Fisher精确概率检验分析庆大霉素胶原海绵使用、年龄、性别、糖尿病史、吸烟史、手术区域、手术等级、手术时间、内固定使用是否为患者手术部位感染相关因素.结果 10例(4.3%)患者手术部位感染,其中3例感染表皮葡萄球菌(S.epidermidis),3例感染耐甲氧西林金黄色葡萄球菌(MRSA),2例感染屎肠球菌(E.faecium),2例未检出病原菌.1例感染者术后使用庆大霉素胶原海绵,9例未使用.手术感染与庆大霉素胶原海绵使用有相关性,而与年龄、性别、糖尿病史、吸烟史、手术区域、手术等级、手术时间、内固定使用无相关性.庆大霉素胶原海绵使用组手术部位感染率(0.9%,1/110)低于非庆大霉素胶原海绵使用组(7.4%,9/122),两组患者的年龄、性别、糖尿病、吸烟史、手术区域、手术等级、手术时间、内固定使用差异无统计学意义(P>0.05).使用庆大霉素胶原海绵患者无不良反应发生.结论 庆大霉素胶原海绵的使用能降低术后手术部位感染风险,有助于患者康复.