骨折内固定术后迟发感染致骨折不愈合24例分析  

Analysis of 24 cases of disunion of fracture due to delayed infection after the internal fixation.

作　　者：武湘云[1] 黄印启[1] 冯和林[3] 李增炎[2] 潘进社[2] 

机构地区：[1]河北医科大学第三医院检验科,石家庄050051 [2]河北医科大学第三医院骨科,石家庄050051 [3]河北医科大学第四医院骨科

出　　处：《中国综合临床》2008年第11期1104-1106,共3页Clinical Medicine of China

基　　金：河北省科技厅资助项目（06276102D-90）

摘　　要：目的探讨骨折内固定术后迟发感染所致骨折不愈合的危险因素、病原学诊断及处理方法。方法回顾性分析24例内固定术后骨折不愈合患者细菌学检查、临床表现及抗生素使用等临床资料。结果24例迟发性感染骨折不愈合患者分离出病原菌22株，细菌检出率91．67％。革兰阳性球菌16株，革兰阴性杆菌6株。革兰阳性球菌对万古霉素、替考拉宁敏感率100％，革兰阴性杆菌对亚胺培南、美罗培南敏感率100％。患者术后使用抗生素较普遍。结论骨折不愈合患者革兰阳性球菌感染多于革兰阴性杆菌；除积极的外科治疗，应以细菌学报告为依据，及时进行合理有效的抗茵药物治疗。Objective To study the risk factors, methods of etiologic diagnosis and treatment of disunion of fracture due to delayed infection after the internal fixation. Methods The clinical data including bacterial tests, clinical manifestation and the administration of antibiotics , of 24 cases of disunion of fracture due to delayed infection after the internal fixation were retrospectively analyzed. Results 22 strains of pathogenic bacteria were distinguished with a detection rate of 91.67% in the 24 cases. 16 strains of these bacteria were gram-positive,and 6 gramnegative. The gram-positive ones were all sensitive to vaneomyein and teieoplanin. The gram-negative ones were all sensitive to imipenem and meropenem. It was common for patients to take antibiotic after operation. Conclusion More infection is caused by gram-positive bacteria than by gram-negative ones. Antibiotic therapy based on the bacterial test is reasonable and necessary besides surgeries.

关 键 词：骨折不愈合 迟发感染 病原菌 敏感性 抗菌治疗 

分 类 号：R687.3[医药卫生—骨科学]