感染预防干预措施对糖尿病患者控制手术部位感染的效果评价

发布时间：2018-05-06 05:38

  本文选题：手术室内干预 + 糖尿病　； 参考：《中华医院感染学杂志》2017年09期

【摘要】：目的探讨手术室内干预措施对并发糖尿病患者手术部位感染的预防控制效果,为提升患者的生存质量提供科学依据。方法选取2012年1月-2015年12月医院行手术治疗并发糖尿病的患者102例,分为干预组与对照组,各51例;对照组患者采用合并糖尿病手术术后干预方案进行干预,干预组采用在常规干预的基础上实施手术室内干预措施;对比两组患者手术部位感染率、感染并发症发生率、病原菌分布及耐药性。结果干预组患者的手术部位感染率(2.0%)显著低于对照组(25.5%),两组比较差异有统计学意义(P0.05);与患者感染并发症发生率相比,干预组患者的感染并发症发生率(7.8%)显著低于对照组(25.5%),两组比较差异有统计学意义(P0.05);14例感染患者中分离出病原菌17株,其中革兰阴性菌占76.5%,主要以大肠埃希菌、阴沟肠杆菌、铜绿假单胞菌为主,分别占35.3%、17.6%、11.8%;革兰阳性菌占17.6%,真菌占5.9%;大肠埃希菌产超广谱β-内酰胺酶株占66.7%,耐药性分析结果显示,对亚胺培南、呋喃妥因、美罗培南耐药率为0,对环丙沙星、氨苄西林、氨曲南耐药性较高,分别占83.3%、100.0%、83.3%。结论并发糖尿病患者手术部位感染以革兰阴性菌为主,手术室内干预措施可显著降低患者的手术部位感染率。
[Abstract]:Objective to explore the effect of intraoperative intervention on the prevention and control of surgical site infection in patients with diabetes mellitus, and to provide scientific basis for improving the quality of life of patients. Methods from January 2012 to December 2015, 102 patients with diabetes were divided into two groups: the intervention group (n = 51) and the control group (n = 51). The intervention group was treated with intraoperative intervention on the basis of routine intervention, and the infection site infection rate, infection complication rate, pathogenic bacteria distribution and drug resistance were compared between the two groups. Results the operative site infection rate in the intervention group was significantly lower than that in the control group (P 0.05), and the incidence of infection complications was significantly higher in the intervention group than in the control group (P 0.05). The incidence of infection complications in the intervention group was significantly lower than that in the control group. There was a statistically significant difference between the two groups. 17 strains of pathogenic bacteria were isolated from 14 cases of infection, of which 76.5 were Gram-negative bacteria, mainly Escherichia coli and Enterobacter cloacae. Pseudomonas aeruginosa was predominant, accounting for 35.3B (17.6C) 11.8; Gram-positive bacteria 17.6am; fungi 5.9m; Escherichia coli producing extended-spectrum 尾 -lactamases (66.7%). Drug resistance analysis showed that resistance rates to imipenem, furantoin, meropenem were 0, and ciprofloxacin to ciprofloxacin, to imipenem, furantoin, meropenem, and to ciprofloxacin, to imipenem, furantoin, meropenem, and to ciprofloxacin. Ampicillin and aztreonam were more resistant to ampicillin and ampicillin, accounting for 83.3% and 83.3%, respectively. Conclusion Gram-negative bacteria are the main infection of surgical site in patients with diabetes mellitus. Intervention in the operating room can significantly reduce the infection rate of surgical sites in patients with diabetes mellitus.
【作者单位】： 内蒙古科技大学包头医学院第一附属医院手术室;内蒙古科技大学包头医学院第一附属医院儿科;内蒙古科技大学包头医学院第一附属医院麻醉科;内蒙古科技大学包头医学院第一附属医院神经外科;内蒙古科技大学包头医学院第一附属医院体检科;
【分类号】：R587.1;R619.3
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本文编号：1851045