急诊外科胸腹部创伤手术后切口感染的病原菌分布及相关危险因素分析

发布时间：2018-01-16 22:26

本文关键词：急诊外科胸腹部创伤手术后切口感染的病原菌分布及相关危险因素分析　出处：《中华医院感染学杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的调查急诊外科胸腹部创伤手术后切口感染的病原菌分布状况,分析相关危险因素。方法回顾性分析2012年3月-2016年3月医院急诊外科528例胸腹部创伤患者的细菌培养结果和临床资料,进行菌种鉴定及统计分析。结果 528例胸腹部创伤患者中发生术后切口感染患者56例,感染率为10.6%;共分离出病原菌72株,以革兰阳性菌为主,占48.6%,革兰阴性菌占44.4%,真菌占6.9%;单因素分析结果显示,急诊外科胸腹部创伤手术后切口感染与年龄、手术时间、住院时间、低白蛋白血症、合并糖尿病和围手术期抗菌药物使用呈明显相关性(χ2=20.420、7.326、12.274、10.254、4.238和11.689,P0.05);logistic回归分析结果显示,年龄、住院时间、合并糖尿病和围手术期抗菌药物使用是急诊外科胸腹部创伤手术后切口感染的独立危险因素(OR=7.126、9.852、4.312和6.597,P0.05)。结论急诊外科胸腹部创伤手术后切口感染以革兰阳性菌为主,年龄、住院时间、合并糖尿病和围手术期抗菌药物使用是其发生的独立危险因素,临床应采取有效措施,控制切口感染的发生。
[Abstract]:Objective to investigate the pathogenic bacteria distribution of wound infection after thoracoabdominal trauma in emergency surgery. Methods the results of bacterial culture and clinical data of 528 patients with chest and abdominal trauma from March 2012 to March 2016 were analyzed retrospectively. Results 56 cases of postoperative wound infection occurred in 528 patients with chest and abdomen trauma, the infection rate was 10.6%. A total of 72 strains of pathogenic bacteria were isolated, mainly Gram-positive bacteria (48.6%), Gram-negative bacteria (44.4%) and fungi (6.9%). Univariate analysis showed that incision infection was associated with age, operation time, hospital stay, and hypoalbuminemia in emergency surgery after thoracoabdominal trauma. There was a significant correlation between diabetes mellitus and perioperative use of antimicrobial agents (蠂 ~ 2 = 20.420, 7.326, 12.274, 10.254, 4.238 and 11.689, respectively). P0.05; Logistic regression analysis showed that age, length of stay. Diabetes mellitus and perioperative antibiotic use were independent risk factors for wound infection after thoracoabdominal trauma in emergency surgery. Conclusion Gram-positive bacteria are the main infection of incision in emergency surgery, age, hospital stay, diabetes mellitus and perioperative use of antibiotics are independent risk factors for the occurrence of incision infection. [WT5HZ] [WT5 "HZ] [WT5" BZ] [WT5 "BZ] [WT5BZ]. Effective measures should be taken to control the incidence of incision infection.
【作者单位】：台州市中西医结合医院急诊科;台州市中心医院肿瘤外科;台州市中心医院肾内科;台州市中西医结合医院院感科;
【基金】：浙江省科技厅科研项目(2013C31129)
【分类号】：R446.5;R619.3
【正文快照】： 急诊外科就诊的胸腹部创伤患者往往病情危急,伤口卫生情况较差,需医护人员在短时间内及时进行清创和术前准备,容易发生切口感染。切口感染不仅不利于患者的术后康复,且如果病原菌进入血液还会威胁患者的生命安全[1]。临床报道显示,引起手术后切口感染的病原菌主要以金黄色葡萄

【相似文献】