摘要
目的探讨基于多学科协作模式(MDT)的集束化策略,应用于预防关节外科手术部位感染的临床研究。方法选取2018年2月—2020年1月关节外科手术患者为研究对象,其中2018年2月—2019年1月资料为对照组,2019年2月—2020年1月资料为干预组。比较两组资料的手术部位感控措施执行率、手术部位感染相关指标,并进行病原学分析。结果干预组1 247例,发生手术部位感染29例,感染率2.33%;对照组1 121例,手术部位感染36例,感染率3.21%,差异无统计学意义(P≥0.05);干预后,多项集束化措施依从性明显提升;干预组住院天数,术中失血量,术后血红蛋白、CRP、WBC、PCT水平与对照组比较,差异有统计学意义(P<0.05);手术部位感染的65例患者共分离出病原菌68株,其中革兰阴性菌、革兰阳性菌和真菌分别占52.94%、44.12%和2.94%。结论落实MDT的集束化策略,多项干预措施依从性有明显提高,围术期相关指标有所改善,对降低手术部位感染率的效益需进一步研究。
Objective To investigate the clinical application of cluster strategy based on Multi-Disciplinary Treatment(MDT) in the prevention of joint surgical site infection.Methods Patients undergoing joint surgery from February 2018 to January 2020 were selected as the study subjects.Data from February 2018 to January 2019 were used as the control group,and data from February 2019 to January 2020 were used as the intervention group.The implementation rate of prevention and control measures of SSIS and related indexes of SSIS were compared between the two groups,and the etiology analysis was conducted.Results In the intervention group,there were 1 247 cases,including 29 cases of surgical site infection(2.33%).In the control group,there were 1,121 cases and 36 cases of surgical site infection,with an infection rate of 3.21%.The difference was not statistically significant(P≧0.05).After intervention,compliance of a number of cluster measures was significantly improved.The hospitalization days,intraoperative blood loss,postoperative hemoglobin,CRP,WBC,and PCT levels of the intervention group were significantly different from those of the control group(P<0.05).A total of 68 strains of pathogenic bacteria were isolated from 65 patients with surgical site infection,among which gram-negative bacteria,gram-positive bacteria and fungi accounted for 52.94%,44.12% and 2.94% respectively.Conclusion With the implementation of MDT’s cluster strategy,compliance of a number of intervention measures has been significantly improved,and perioperative related indicators have been improved.Further research is needed on the benefit of reducing surgical site infection rate.
作者
王锦
王晓君
WANG Jin;WANG Xiao-jun(Qingdao Municipal Hospital,Qingdao Shandong 266011;Qilu Hospital of Shandong University,China)
出处
《中国消毒学杂志》
CAS
2021年第6期452-455,共4页
Chinese Journal of Disinfection
基金
中华医院感染控制研究基金(ZHYY 2015-0029)。
关键词
多学科协作诊疗
集束化策略
关节外科
手术部位感染
临床研究
Multi-Disciplinary Treatment
cluster strategy
joint surgery
surgical site infection
clinical research
