关键词: 口腔外科手术, 外科感染, 细菌感染, 危险因素, 抗菌药物

Abstract:

Objective To retrospectively analyze the etiological characteristics and risk factors for postoperative infection in the patients who underwent oral and maxillofacial surgery， and to provide the reference for clinical infection prevention and control and formulation of antibacterial treatment strategies. Methods A total of 462 inpatients were selected who underwent oral and maxillofacial surgical treatment at our hospital from May 2021 to September 2024. Based on the occurrence of postoperative infection， they were divided into infection group （130 cases） and non-infection group （332 cases）. The distribution and the antibacterial drug susceptibility of the pathogenic bacteria in clinical specimens from the patients in infection group were analyzed. Univariable analysis was performed for the surgical data of the patients in two groups， and variables showing significant differences were further included in the multivariable Logistic regression model to screen for independent risk factors for postoperative infection in oral and maxillofacial surgery patients. Results In clinical specimens from the patients in infection group， Gram-negative bacteria were the main pathogens （57.4%）， with the susceptibility rates of common strains to cefepime， meropenem， and levofloxacin and so on exceeding 90%. The susceptibility rates of Gram-positive bacteria such as Staphylococcus and Streptococcus to vancomycin and chloramphenicol were greater than 70%. The univariate analysis results showed that there were statistically significant differences between the patients in two groups in age， surgical risk assessment level， surgical complexity， intraoperative blood loss， duration of surgery， placement of post-operative drainage device， implantation of medical device and performance of temporary tracheotomy （P<0.05）. The results of multivariate Logistic regression analysis showed that high surgical complexity （P=0.022）， increased intraoperative blood loss （P=0.005）， and high surgical risk assessment level （P=0.001） were the independent risk factors for postoperative infection in the patients underwent oral and maxillofacial surgery. Conclusion Postoperative infections in oral and maxillofacial surgery are mainly caused by Gram-negative bacteria， and antibacterial therapy should be guided by drug susceptibility results. Perioperative management should be intensified for high-risk patients to reduce the incidence of infection.

Key words: Oral surgery, Surgical infection, Bacterial infection, Risk factor, Antibacterial drug