四肢骨折内固定术后手术部位感染危险因素

发布时间：2018-02-01 20:02

  本文关键词： 骨折 内固定术 手术部位感染 术后感染 危险因素　出处：《中国感染控制杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的了解四肢骨折患者内固定术后手术部位感染(SSI)的发病率和危险因素。方法收集某院2013年1月—2016年1月收治的四肢骨折接受内固定手术治疗的患者资料,将术后发生SSI的39例患者纳入感染组,按1∶2的比例随机抽取同期术后未发生SSI的78例患者作为对照组,分析SSI的危险因素。结果 4 125例骨折内固定患者术后SSI发生率为0.95%(39例),感染组细菌培养阳性率为87.2%(34/39),共分离病原菌38株,其中革兰阳性菌22株(57.9%),革兰阴性菌15株(39.5%),真菌1株(2.6%),金黄色葡萄球菌是主要致病菌(47.4%),多重耐药菌20株。单因素分析结果显示,合并基础疾病、受伤至手术时间≥8 h、开放性骨折、多处骨折、手术时间≥180 min、术中失血量≥400 mL、术中输入异体血、术后引流管留置时间≥5 d、平均住院时间≥14 d,感染组与对照组比较,差异有统计学意义(均P0.05)。多因素logistic回归分析结果显示,受伤至手术时间≥8 h、开放性骨折、手术时间≥180 min、术后引流管留置时间≥5 d、住院时间≥14 d是骨折内固定术后SSI的危险因素(均P0.05)。结论四肢骨折内固定术后患者发生SSI的危险因素较多,减少危险因素,对降低SSI发生率,提高治愈率有积极作用。
[Abstract]:Objective to investigate the infection of surgical site in patients with extremity fracture after internal fixation. Methods data of patients with limb fractures treated with internal fixation from January 2013 to January 2016 were collected. Thirty-nine patients with postoperative SSI were included in the infection group, and 78 patients without SSI were randomly selected as the control group according to the ratio of 1: 2. The risk factors of SSI were analyzed. Results the incidence of SSI in 4 125 patients with internal fixation of fracture was 0. 95% and 39 cases respectively). The positive rate of bacterial culture in the infected group was 87.2 / 39. 38 strains of pathogenic bacteria were isolated, of which 22 strains were Gram-positive bacteria and 15 strains were Gram-negative bacteria. Staphylococcus aureus was the main pathogen, and there were 20 strains of multidrug resistant bacteria. The results of univariate analysis showed that combined with basic diseases, the time from injury to surgery was more than 8 hours. Open fractures, multiple fractures, operative time 鈮，

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