成都某三甲骨科医院化脓性骨髓炎患者临床特征及预后分析OA
Analysis of Clinical Characteristics and Risk Factors of Patients with Suppurative Osteomyelitis in a Tertiary Ortho-pedic Hospital in Chengdu
目的 回顾性分析成都某三甲骨科医院化脓性骨髓炎患者感染部位、病原菌分布、感染指标等临床特征及预后情况.方法 收集四川省骨科医院2022 年7 月至2024 年12 月收治的化脓性骨髓炎患者临床资料、感染指标、细菌培养结果等信息,分析骨髓炎患者感染部位、病原菌的分布、多重耐药菌检出率、感染指标差异等.根据出院情况将患者分为预后良好组和预后不良组,多元 Logistic 回归模型分析预后因素.结果 563 例化脓性骨髓炎患者男女比例为2.59∶1;年龄中位数54(43,63)岁;胫骨感染228 例(40.50%).563 例骨髓炎患者共分离出病原菌 645 株,以金黄色葡萄球菌285 株(44.19%)最常见;检出耐甲氧西林的金黄色葡萄球菌(MRSA)100 株,产碳青霉烯酶(CRE)细菌10 株.患者入院时血清降钙素原(PCT)、白细胞介素-6(IL-6)水平与住院天数呈正相关(均 P＜0.05);急性组患者住院天数、PCT、IL-6 水平高于慢性组(P＜0.05);多元 Logistic 回归显示急慢性骨髓炎、PCT、IL-6 是化脓性骨髓炎的预后因素.结论 化脓性骨髓炎多见于男性,好发于胫骨,常见病原菌为金黄色葡萄球菌,MRSA 的检出率较高.急慢性骨髓炎、炎症指标PCT、IL-6 是化脓性骨髓炎的预后因素.
Objective To conduct a retrospective analysis on the clinical characteristics and prognosis of patients with suppurative osteomyelitis in a tertiary orthopedic hospital in Chengdu,including the infection sites,distribution of pathogenic bacte-ria,and infection indicators.Methods Clinical data,infection indicators,and bacterial culture results of patients with osteomyelitis admitted to Sichuan Provincial Orthopedic Hospital from July 2022 to December 2024 were collected.The distribution of infection sites,pathogenic bacteria,detection rate of multi-drug resistant bacteria,and differences in infection indicators among osteomyelitis patients were analyzed.According to the discharge conditions,the patients were divided into a good prognosis group and a poor prognosis group.Multivariate Logistic regression model was used to analyze the prognostic factors.Results The male to female ra-tio of 563 patients with suppurative osteomyelitis was 2.59∶1,the median age was 54(43,63)years.Tibia was the most common site of infection with 228 cases(40.50%).A total of 645 strains of pathogenic bacteria were isolated from 563 patients,and Staph-ylococcus aureus 285 strains(44.19%)was the most common.100 strains of methicillin-resistant Staphylococcus aureus(MRSA)and 10 strains of carbapenemase-producing bacteria(CRE)were detected.The serum levels of procalcitonin(PCT)and interleu-kin-6(IL-6)at admission were positively correlated with the length of stay(P＜0.05).Hospitalization days,PCT and IL-6 levels in the acute attack group were higher than those in the chronic group(P＜0.05).Multiple Logistic regression showed that acute and chronic osteomyelitis,PCT and IL-6 were prognostic factors of suppurative osteomyelitis.Conclusion Suppurative osteomyeli-tis is more common in men and occurs in tibia.Staphylococcus aureus is the most common pathogenic bacterium,and the detection rate of MRSA is relatively high.Acute or chronic osteomyelitis,inflammatory markers PCT and IL-6 are prognostic factors of suppu-rative osteomyelitis.
刘小莉;邹明;王秦;池继敏;张静
四川省骨科医院检验科,四川 成都 610041四川省骨科医院检验科,四川 成都 610041四川省骨科医院检验科,四川 成都 610041四川省骨科医院检验科,四川 成都 610041四川省骨科医院检验科,四川 成都 610041
医药卫生
骨髓炎病原菌耐药危险因素
osteomyelitispathogendrug resistancerisk factors
《四川医学》 2026 (4)
383-387,5
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