郭艳,徐菊红,李占结,刘静

• 1:郑州市第一人民医院医院感染管理科
• 2:南京医科大学第一附属医院
• 3:许昌市中心医院医院感染管理科

摘要(Abstract)：

目的 探讨神经外科手术患者手术部位感染（SSI）的危险因素及预测模型的构建，为相关风险防控提供依据。方法 收集2014—2023年郑州市某三级甲等医院神经外科手术患者的临床资料，单因素分析筛选SSI危险因素，基于二分类logistic回归构建预测模型，通过ROC曲线和校准曲线评价模型。结果 11 116例神经外科手术患者中，353例发生SSI,SSI发生率为3.18%。SSI类型以器官/腔隙感染为主，占94.05%(332/353)，感染病原体以革兰阴性菌为主，占56.06%(37/66)。logistic回归分析显示，年龄>51.5岁（OR=1.413,95%CI:1.135～1.759）、手术时长>2.775 h(OR=2.613,95%CI:2.070～3.299)、非清洁切口（OR=1.836, 95%CI:1.097～3.072）和术后发热（OR=12.434, 95%CI:8.516～18.153）是SSI的独立危险因素；术后预防用药（OR=0.219, 95%CI:0.070～0.690）是SSI的独立保护因素。模型ROC曲线下面积0.818(95%CI:0.800～0.837)，敏感性为0.878，特异性为0.628；校准曲线和Hosmer-Lemeshow检验（P=0.617）表明预测模型具有良好的校准度。结论 神经外科患者术后预防使用抗菌药物可以降低SSI，患者年龄大、手术时间长、非清洁切口和术后发热是SSI的危险因素，基于以上因素构建的模型可有效预测SSI发生风险。

关键词(KeyWords)： 手术部位感染;神经外科;危险因素;预测模型

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 郭艳,徐菊红,李占结,刘静

DOI: 10.13515/j.cnki.hnjpm.1006-8414.2025.06.010

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