开放性手术治疗对老年骨折患者生活质量的影响及创口感染危险因素分析

发布时间：2018-09-19 13:06

【摘要】：目的探讨开放性手术治疗对老年骨折患者生活质量的影响及创口感染危险因素分析。方法接受开放性手术治疗的骨折且临床资料完整的老年患者863例,回顾性分析开放性手术后创口感染的相关因素。并根据患者是否采用内固定分为内固定组(n=573)和无固定组(n=290);另选同期于该院体检的老年患者263例为对照组,采用欧洲五维健康量表(EQ-5D)对3组健康生活质量进行评定。结果 863例开放性骨折患者术后90例创口发生感染,感染率为10.43%。性别、年龄等因素与感染无相关性;病情度、体质量指数25 kg/m2、应用内固定、有并发症、死腔、损伤至手术时间6 h及手术清创不彻底等因素均与术后创口感染有显著相关(P0.05);而损伤至手术时间6 h、应用内固定和创口遗留死腔是老年骨折行开放性手术治疗后导致创口感染的独立危险因素(P0.05)。EQ-5D评分可知:内固定组和无固定组生活质量评分均低于对照组,而无固定组在行动、自我照顾和日常活动等能力评分高于内固定组,而在疼痛或不适、焦虑或抑郁等方面评分低于内固定组(P0.05)。感染创口病原菌培养:检出病原菌165株,其中排名前3为铜绿假单细胞菌、大肠埃希菌、金黄色葡萄球菌。结论了解开放性骨折患者术后创口感染的危险因素、病原菌构成,有利于术后对患者采取相应的预防措施,降低术后创口感染率,提高患者生活质量。
[Abstract]:Objective to investigate the effect of open operation on quality of life and risk factors of wound infection in elderly patients with fracture. Methods 863 patients with fracture and complete clinical data were treated by open surgery. The factors related to wound infection after open surgery were analyzed retrospectively. According to whether the patients were treated with internal fixation or not, they were divided into internal fixation group (nn 573) and non fixed group (n = 290), and 263 elderly patients who were examined in the same period were selected as control group. The healthy quality of life of the three groups was evaluated by European five dimensional Health scale (EQ-5D). Results infection occurred in 90 patients with open fracture after operation, and the infection rate was 10.43. Sex, age and other factors were not related to infection, the degree of disease, body mass index (BMI) 25 kg/m2, were used for internal fixation, complications, dead cavity, There was a significant correlation between postoperative wound infection and postoperative wound infection (P0.05), while internal fixation and residual cavity were used after open surgical treatment for senile fracture (P05), and the operative time from injury to 6 hours was significantly correlated with postoperative wound infection (P0.05), while the time from injury to operation was 6 hours and the operative debridement was incomplete (P0.05). The independent risk factors leading to wound infection (P0.05). EQ-5D score showed that the quality of life scores in the internal fixation group and the non-fixed group were lower than those in the control group. The scores of movement, self-care and daily activities in the non-fixed group were higher than those in the internal fixation group, while the scores in pain or discomfort, anxiety or depression were lower than those in the internal fixation group (P0.05). Infection wound pathogen culture: 165 strains of pathogens were detected, among which the top 3 were Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus. Conclusion to understand the risk factors and pathogenic bacteria composition of wound infection in patients with open fracture is beneficial to take corresponding preventive measures to reduce the postoperative wound infection rate and improve the quality of life of the patients.
【作者单位】：六盘水市人民医院;
【分类号】：R687.3

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