骨外科患者术后医院感染因素及围手术期干预措施研究

发布时间：2018-06-29 04:32

本文选题：骨外科 + 医院感染　；参考：《中华医院感染学杂志》2017年11期

【摘要】：目的探讨骨外科患者术后医院感染因素及围手术期干预措施,为临床预防及治疗提供有效手段。方法选取2014年9月-2016年7月医院骨外科收治的患者600例,所有患者填写统一制定的感染回顾调查表,详细记录性别、年龄、合并基础疾病等,实验室检查结果,全面评估患者医院感染情况,详细记录感染部位、感染时长等情况,对患者进行相关病原菌检查,对结果进行相关分析,制定基本因素的评估分界点,分析医院感染可能的危险因素。结果 600例骨外科住院患者术后发生医院感染68例,感染率为11.33%,其中交通事故患者发生医院感染18例占26.48%,股骨粉碎性骨折患者发生医院感染22例占32.35%;68例感染患者中呼吸道感染35例占51.47%,切口感染12例占17.65%,胃肠道感染19例占27.94%;将68例感染患者样本进行病原菌检测,共检出革兰阳性菌36株52.17%,革兰阴性菌32株占46.38%,真菌1株占1.45%;患者高龄、合并糖尿病、手术切口类型为II型、手术时机为急诊期医院感染率高,差异有统计学意义(P0.05);患者年龄,合并糖尿病,切口类型及手术时机均是医院感染发生的独立危险因素。结论骨外科术后住院患者中股骨粉碎性骨折、跌倒骨折、交通事故是医院感染发生率较高群体,其中呼吸道感染为多发医院感染类型,医院感染的发生与患者高龄、合并糖尿病、手术切口II类、急诊手术呈正相关。
[Abstract]:Objective to explore the factors of postoperative nosocomial infection and perioperative intervention in patients with bone surgery, and to provide effective means for clinical prevention and treatment. Methods from September 2014 to July 2016, 600 patients with bone surgery in our hospital were selected. All the patients filled out the unified infection retrospective questionnaire, and recorded the gender, age, underlying diseases, laboratory results, etc. To comprehensively assess the nosocomial infection of the patients, to record the infection site, to record the infection time and so on, to examine the pathogens of the patients, to analyze the results, and to draw up the evaluation boundary of the basic factors. To analyze the possible risk factors of nosocomial infection. Results there were 68 cases of nosocomial infection in 600 cases of bone surgery inpatients. The infection rate was 11.33. The nosocomial infection occurred in 18 cases of traffic accident patients (26.48%), the incidence of nosocomial infection in 22 cases of comminuted fracture of femur (32.35%), respiratory tract infection in 35 cases (51.47%), incision infection in 12 cases (17.65%) and gastrointestinal tract infection in 12 cases. The pathogenic bacteria were detected in 68 samples of infected patients. A total of 36 Gram-positive bacteria were detected, 32 Gram-negative bacteria accounted for 46.38 and 1 fungus accounted for 1.45.The elderly patients, diabetes mellitus, surgical incision type II, the operation timing for the emergency hospital infection rate was high, the difference was statistically significant (P0.05); Diabetes mellitus, incision type and surgical timing are independent risk factors for nosocomial infection. Conclusion comminuted fracture of femur, falling fracture and traffic accident are the high incidence of nosocomial infection in the inpatients after operation of bone surgery. Respiratory tract infection is the type of multiple nosocomial infection, and nosocomial infection is associated with the age of the patients. With diabetes mellitus, surgical incision type II, emergency surgery positive correlation.
【作者单位】：绍兴第二医院手术室;绍兴第二医院骨科;绍兴第二医院检验科;
【基金】：浙江省医药卫生一般研究计划基金资助项目(2015KYB409)
【分类号】：R687

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