目的：探讨踝关节和 Pilon 骨折术后手术部位感染的危险因素，为预防手术部位感染提供理论依据。方法对2005年6月—2013年5月某院踝关节和 Pilon 骨折手术患者资料进行回顾性调查，对手术部位感染相关危险因素进行分析。结果356例踝关节和 Pilon 骨折手术患者，发生手术部位感染22例、25例次，手术部位感染发病率为6．18％，例次感染发病率为7．02％。单因素分析结果显示，高龄（＞60岁）、有糖尿病史、术前行跟骨牵引、围手术期不合理使用抗菌药物、手术切口类型、手术时间长（＞3 h）是踝关节和 Pilon 骨折术后手术部位感染的危险因素（均 P ＜0．05），多因素 logistic 回归分析结果显示：手术切口类型[OR 及 OR95％CI ：3．58（3．24—12．07）]、糖尿病史[OR 及OR95％CI ：2．75（1．54—4．75）]、手术时间[OR 及 OR95％CI ：2．15（1．32—3．64）]及患者年龄[OR 及OR95％CI ：1．68（1．25—2．37）]是手术部位感染的独立危险因素。结论踝关节和 Pilon 骨折术后手术部位感染与多种因素相关，应针对相关危险因素采取积极的预防和控制措施，减少感染的发生。%Objective To evaluate the risk factors for surgical site infection(SSI)following ankle joint and Pilon fracture surgery,and provide theoretical basis for the prevention of postoperative SSI.Methods Clinical data of pa-tients who underwent ankle joint and Pilon fracture surgery in a hospital between June 2005 to May 2013 were sur-veyed retrospectively,risk factors for SSI were analyzed.Results Among 356 patients with ankle joint and Pilon fracture surgery,22 developed 25 times of SSI,SSI rate was 6.18%,case infection rate was 7.02%.Univariate analysis showed that elderly patients (> 60 years old),history of diabetes,pre-operative calcaneal traction, perioperative irrational antimicrobial use,incision type,and long duration of operation (>3 h)were risk factors for SSI following ankle joint and Pilon fracture surgery (all P <0.05).Multivariate logistic regression analysis showed that the independent risk factors for SSI were incision type(OR,3.58[95%CI ,3.24-12.07]),history of diabetes (OR,2.75[95%CI ,1 .54-4.75]),duration of operation(OR,2.15[95%CI ,1 .32-3.64]),and patients age(OR, 1 .68[95%CI ,1 .25-2.37]).Conclusion Occurrence of SSI following ankle joint and Pilon fracture surgery is related to multiple factors,corresponding prevention and control measures should be taken to reduce the occurrence of SSI.
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