摘要
目的分析上肢开放性骨折患者创口感染的临床资料、病原菌分布特点及预防措施。方法回顾性分析2015年4月至2017年10月绍兴市人民医院收治的545例上肢开放性骨折患者中96例感染患者的临床资料,对感染创口分泌物进行病原菌鉴定,并利用统计学软件对调查记录的数据进行分析。结果 96例上肢开放性骨折感染患者的骨折位置以肱骨骨折的患者最多(85.83%)、致伤原因中以交通意外伤患者数量最多(40.63%)、损伤程度上,custilo分型Ⅲ型比例最高(64.58%)。上肢开放性骨折患者创口感染与骨折损伤程度、手术间隔时间、手术时间及住院时间有关,差异有统计学意义(P<0.05)。545例上肢开放性骨折患者发生创口感染96例,感染率17.61%,96例送检标本共培养出病原菌87株,革兰阴性菌51株(58.62%),革兰阳性菌31株(35.63%),真菌5株(5.75%),三者比较,差异有统计学意义(P<0.05)。结论上肢开放性骨折患者创口感染多发于肱骨骨折位置,与骨折损伤程度、手术间隔时间、手术时间、住院时间等因素相关,病原菌类型以革兰阴性杆菌为主。因此加强对骨折位置的保护,合理高效提升手术时间,加强个性化护理,减少住院时间,同时针对病原菌的敏感度合理选择药物,能够有效降低上肢开放性骨折创口感染发生率,提高临床治疗效果。
Objective To analyze the clinical data,pathogens and preventive measures of wound infection in patients with open upper limb fractures.Methods A retrospective analysis on the clinical data of 96 cases with wound infections of open arm fractures treated in our hospital from April 2015 to October 2017 was performed.Wound secretion samples were collected for the identification of pathogens.Data was analyzed using statistical software.Results Most upper limb fractures happened in humerus,accounting for 85.83%of total fractures.40.63%of the upper limb fractures were caused by traffic accidents and most of the fractures(64.58%)were categorized as Custilo type III.The wound infection of the open upper limb fractures was related to the degree of fracture,the interval of operation,the time of operation and hospital stay,the differences were statistically significant(P<0.05).96 out of 545 cases with open upper limb fractures had wound infections with the infection rate of 17.61%.A total of 87 strains of pathogens were isolated with 51 strains of Gram-negative bacteria(58.62%),31 strains of Gram-positive bacteria(35.63%),5 strains of fungi(5.75%)and there were significant differences(P<0.05).Conclusions Majority of the wound infections occur in open humerus fractures,which is related to the degree of fracture,the interval of operation,the time of operation and hospital stay.Gram-negative bacilli were the predominant pathogens for wound infections.Therefore,it is important to protect the open fracture itself,shorten the interval and time of surgery,reduce the days of hospital stay and conduct drug susceptibility test in order to prevent wound infections of open arm fractures.
作者
平建锋
孙文东
车斌
陈雪荣
PING Jian-feng;SUN Wen-dong;CHE Bin;CHEN Xue-rong(Department of orthopedics,Shaoxing People′s Hospital,Shaoxing hospital of Zhejiang University,Shaoxing,Zhejiang 312000,China)
出处
《中国预防医学杂志》
CAS
CSCD
2019年第5期418-421,共4页
Chinese Preventive Medicine
基金
浙江省医药卫生科研基金资助项目(2017KY662)
关键词
上肢骨折
创口感染
病原菌
预防
upper limb fracture
wound infection
pathogen
prevention
