摘要
目的探讨手术室内干预措施对并发糖尿病患者手术部位感染的预防控制效果,为提升患者的生存质量提供科学依据。方法选取2012年1月-2015年12月医院行手术治疗并发糖尿病的患者102例,分为干预组与对照组,各51例;对照组患者采用合并糖尿病手术术后干预方案进行干预,干预组采用在常规干预的基础上实施手术室内干预措施;对比两组患者手术部位感染率、感染并发症发生率、病原菌分布及耐药性。结果干预组患者的手术部位感染率(2.0%)显著低于对照组(25.5%),两组比较差异有统计学意义(P<0.05);与患者感染并发症发生率相比,干预组患者的感染并发症发生率(7.8%)显著低于对照组(25.5%),两组比较差异有统计学意义(P<0.05);14例感染患者中分离出病原菌17株,其中革兰阴性菌占76.5%,主要以大肠埃希菌、阴沟肠杆菌、铜绿假单胞菌为主,分别占35.3%、17.6%、11.8%;革兰阳性菌占17.6%,真菌占5.9%;大肠埃希菌产超广谱β-内酰胺酶株占66.7%,耐药性分析结果显示,对亚胺培南、呋喃妥因、美罗培南耐药率为0,对环丙沙星、氨苄西林、氨曲南耐药性较高,分别占83.3%、100.0%、83.3%。结论并发糖尿病患者手术部位感染以革兰阴性菌为主,手术室内干预措施可显著降低患者的手术部位感染率。
OBJECTIVE To explore the effect of interventions in operating room on prevention and control of surgical site infection in patients complicated with diabetes mellitus so as to provide guidance for improvement of quality of life of the patients.METHODS A total of 102 patients complicated with diabetes mellitus who received surgical procedures in the hospital from Jan 2012 to Dec 2015 were enrolled in the study and divided into the intervention group and the control group,with 51 cases in each.The control group was treated with postoperative interventions,while the intervention group was given the interventions in operating rooms on the basis of the conventional interventions.The incidence of surgical site infection,incidence of complications,and distribution and drug resistance of pathogens were observed and compared between the two groups of patients.RESULTS The incidence rate of surgical site infection of the intervention group was 2.0%,significantly lower than 25.5% of the control group（P〈0.05）.The incidence of complications with infection was 7.8% in the intervention group,significantly lower than 25.8%in the control group（P〈0.05）.Totally 17 strains of pathogens were isolated from the 14 patients with infections,of which 76.5% were gram-negative bacteria,17.6% were gram-positive bacteria,and 5.9%were fungi;Escherichia coli,Enterobacter cloacae,and Pseudomonas aeruginosa were dominant among the gramnegative bacteria,accounting for 35.3%,17.6%,and 11.8%,respectively.The extended-spectrumβ-lactamasesproducing E.coli strains accounted for 66.7%.The result of analysis of drug resistance indicated that the drug resistance rates to imipenem,nitrofurantoin,and meropenem were 0.0%,and the drug resistance rates to ciprofloxacin,ampicillin,and aztreonam were 83.3%,100.0%,and 83.3%,respectively.CONCLUSIONThe gram-negative bacteria are dominant among the pathogens causing the surgical site infection in the patients complicated with diabetes mellitus.The interventions in operating rooms may remarkably reduce th
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第9期2129-2132,共4页
Chinese Journal of Nosocomiology
关键词
手术室内干预
糖尿病
感染
预防控制
Intervention in operating room
Diabetes mellitus
Infection
Prevention and control
