股骨颈修复手术部位感染目标性监测分析

发布时间：2018-03-04 13:23

本文选题：股骨颈修复　切入点：手术部位感染　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对行股骨颈修复手术患者开展手术部位感染目标性监测,了解手术部位感染发生率和手术部位感染危险因素,逐步推进各项干预措施,提高干预措施的依从性,降低手术部位感染发生率。方法:对山西省两所三级医院2015年1月1日-2016年12月31日行股骨颈修复手术的493例患者进行目标性监测,由课题组成员统一填写《手术部位感染监测表》和《手术部位感染防控措施依从性监测表》,调查内容包括患者的基本信息、手术信息、手术部位感染情况、是否采用干预措施等情况。所有数据均使用SPSS17.0统计软件进行处理,对患者的一般资料采用率、百分比等描述性指标,探讨股骨颈修复患者发生手术部位感染的发生现状及引发感染的危险因素。结果:1.2015-2016年共监测股骨颈修复手术患者493例,男性221例,女性272例。年龄13岁-97岁,平均年龄为(66.27±15.23)岁,共7例发生手术部位感染,发生率为1.42%。其中表浅切口感染发生5例,占71.43%,深部切口感染发生2例,占28.57%。均未发生器官腔隙感染。2.将各手术医师的手术部位感染发生率进行调正分析。感染专率调正前排名前三的依次为代号9(3.70%),5(2.70%),0(1.64%)的医师,调正后排名前三的依次为代号5(1.78%),2(1.65%),3(1.58%)的医师。3.7例发生手术部位感染患者,其中6例进行标本送检,共检出9株病原菌,均为革兰氏阴性菌,其中鲍曼不动杆菌(3株),居首位;无真菌和病毒感染的发生。病原菌均为条件致病菌。结论:术前住院天数过长、术后住院天数过长、切口污染程度严重、手术持续时间过长、手术危险指数高是手术部位感染的危险因素,积极推进干预措施,发现和解决干预措施推进过程中存在的问题,可有效降低手术部位感染的发生。
[Abstract]:Objective: to investigate the incidence of surgical site infection and the risk factors of site infection in patients undergoing femoral neck repair, and to promote the intervention step by step and improve the compliance of intervention measures. Methods: objective surveillance was performed on 493 patients undergoing femoral neck repair from January 1st 2015 to December 31st 2016 in two tertiary hospitals in Shanxi Province. The members of the research group filled out the "Surveillance form of infection at Operation site" and "Compliance Monitoring form of Prevention and Control measures for infection of Operation site". The contents of the investigation included the basic information of patients, the information of operation and the situation of infection of surgical site. All the data were processed by SPSS17.0 statistical software, and the rate and percentage of the general data of the patients were used as descriptive indicators. To investigate the present situation of surgical site infection in femoral neck repair patients and the risk factors of infection. Results A total of 493 femoral neck repair patients (221 males and 272 females) were monitored during 2015-2016. The average age was 66.27 卤15.23 years (ranging from 13 to 97 years). The operative site infection occurred in 7 cases (1.42%), including superficial incision infection in 5 cases (71.43%), deep incision infection in 2 cases, deep incision infection in 2 cases, superficial incision infection in 5 cases (71.43 cases), deep incision infection in 2 cases. No organ lacunar infection was found in 28.57.The incidence of infection at the surgical site of each surgeon was adjusted and positive analysis was carried out. The first three who ranked the first three before adjusting the specific rate of infection were the doctors with the code number 93.70, 52.70 and 1.64, respectively. The first three of them were doctors who had infection in operation site, including 6 cases, 9 strains of pathogenic bacteria were detected, all of them were Gram-negative bacteria. Among them, 3 strains of Acinetobacter baumannii were in the first place, among them, 3 strains of Acinetobacter baumannii were in the first place. The pathogenic bacteria are conditional pathogens. Conclusion: the days of hospitalization before and after operation are too long, the degree of wound contamination is serious, the duration of operation is too long. High surgical risk index is the risk factor of surgical site infection. It can effectively reduce the incidence of surgical site infection by actively promoting intervention measures and finding and solving the problems existing in the process of intervention.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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