软组织扩张中扩张囊内外的细菌学分析  

Bacteria examination and analysis intra-expander and extra-expander during tissue expansion

作　　者：张卓男[1] 范金财[1] 杜水果[1] 赵永刚[1] 乌丽[1] 何晶晶[1] 林雨[1] 王晓东[1] 

机构地区：[1]中国医学科学院中国协和医科大学整形外科医院,北京100041

出　　处：《中国美容整形外科杂志》2007年第2期157-159,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的研究软组织扩张术患者扩张囊内、外的细菌数量及种类,为临床上防治扩张术感染提供依据。方法连续采集33例扩张术患者的51枚扩张囊内、外的液体标本,进行常规细菌培养和药敏试验,并将其结果进行统计学处理,采用χ2检验和Kappa检验。结果扩张囊内、外的细菌检出率分别为3.92%(2枚)、17.65%(9枚),囊外阳性率显著高于囊内(P<0.05),囊内、外细菌的检出结果一致性较差(Kappa<0.4)。细菌种类为金黄色葡萄球菌和凝固酶阴性葡萄球菌,对庆大霉素、去甲万古霉素、环丙沙星均敏感。33例患者(51枚)中,有10例患者(10枚)检出细菌,仅有1例患者(1枚)出现临床感染症状,致病菌为金黄色葡萄球菌。结论严格消毒后进行穿刺注水导致感染的几率很低,而感染后的细菌培养和药敏试验是治疗的关键。Objective To evaluate infection during tissue expansion, and find more sensitive drugs to prevent tissue expander infection. Methods Intra- expander and extra- expander specimens from 51 tissue expanders used in 33 expanded patents were cultured under aerobic conditions. Bacterial culture and drug sensitivity were evaluaed. The results for intra- expander and extra- expander groups were analyzed statistically by x^2 and kappa test. Results The positive infection rate of the intra- expander group （3.92%） was higher than that of the extra - expander group （17.65 % ）. The difference between the two groups was statistical significant （P〈 0.05）. The concordance of bacteria found in these two groups was poor （Kappa〈0.4）. The bacterial types found in intra- expander and extra - expander specimens were staphyloccoccu auras and coagulase - negative staphylooocci which were sensitive to gentamlcin, vancomycin, ciprofloxacin. Only one tissue expander had a clinical infection which resulted from staphylococcus aureus. Conclusion With normal sterilization procedures, the infection incidence resulting from puncture way was very low. Bacterial culture and drug sensitivity tests are effective procedures to guide treatment.

关 键 词：扩张术 感染 细菌培养 

分 类 号：R622[医药卫生—整形外科]