创伤性骨折患者艰难梭状芽孢杆菌感染的流行病学调查及对临床预后的影响

发布时间：2018-07-23 14:56

【摘要】：目的探讨创伤性骨折患者艰难梭状芽孢杆菌感染的流行病学调查及对患者临床预后的影响,为创伤性骨折患者艰难梭状芽孢杆菌感染的临床预防提供可靠依据。方法选择2012年5月-2016年5月医院骨科收治的创伤性开放性骨折合并腹泻患者185例,将检出艰难梭状芽孢杆菌感染28例患者作为阳性组,再选择60例无艰难梭状芽孢杆菌感染患者作为阴性组,分析艰难梭状芽胞杆菌感染危险因素、艰难梭状芽胞杆菌感染对患者血清炎症因子水平的影响以及对患者日常生活能力(ADL)评分及住院时间的影响。结果送检185份标本中,共检出艰难梭状芽孢杆菌毒素检测阳性28份,阳性率15.14%;单因素及多因素logistic分析显示,合并胃肠道疾病及腹泻天数为创伤性开放性骨折患者发生艰难梭状芽胞杆菌感染的独立危险因素;艰难梭状芽孢杆菌感染阳性组患者其血清降钙素原(PCT)、白细胞介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)水平显著高于阴性组,差异有统计学意义(P0.05);艰难梭状芽孢杆菌检出阳性组患者其ADL评分显著低于阴性组,差异有统计学意义(P0.05),阳性组住院时间显著长于阴性组,差异有统计学意义(P0.05)。结论合并胃肠疾病及长时间腹泻是创伤性开放性骨折住院患者艰难梭状芽孢杆菌感染的独立危险因素,艰难梭状芽孢杆菌感染将引起患者机体炎症水平的升高,影响患者预后。
[Abstract]:Objective to investigate the epidemiological investigation of Clostridium difficulty infection in patients with traumatic fracture and its influence on the clinical prognosis, so as to provide a reliable basis for the clinical prevention of Clostridium difficulty infection in patients with traumatic fracture. Methods 185 patients with traumatic open fracture complicated with diarrhea were selected from May 2012 to May 2016. 28 patients with Clostridium difficulty infection were selected as positive group. 60 patients without Clostridium challenge infection were selected as negative group, and the risk factors of Clostridium challenge infection were analyzed. The effect of Clostridium difficulty infection on serum inflammatory factor level, (ADL) score and hospitalization time of patients with ADL. Results out of 185 samples, 28 were positive for Clostridium diffcult toxin, the positive rate was 15.14.The single factor and multivariate logistic analysis showed that, The days of gastrointestinal diseases and diarrhea were independent risk factors of Clostridium difficulty infection in patients with traumatic open fracture. The serum levels of procalcitonin (PCT), interleukin-6 (IL-6) and hypersensitive C- reactive protein (hs-CRP) in patients with Clostridium challenge infection were significantly higher than those in the negative group. The difference was statistically significant (P0.05); the ADL score of the positive group was significantly lower than that of the negative group (P0.05). The hospitalization time of the positive group was significantly longer than that of the negative group (P0.05). Conclusion Gastrointestinal disease and long time diarrhea are independent risk factors of Clostridium difficulty infection in patients with traumatic open fracture. Clostridium difficulty infection will cause the increase of inflammatory level of patients and affect the prognosis of patients.
【作者单位】：温岭市第一人民医院骨科;温岭市第一人民医院外科;温岭市第一人民医院急诊科;
【基金】：浙江省医药卫生一般研究计划基金资助项目(2015KYB448)
【分类号】：R683

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