骨科患者感染的危险因素调查  

Risk factors for nosocomial infections in orthopedic patients

作　　者：虞伟力[1] 

机构地区：[1]浙江中医药大学附属第二医院骨一科,浙江杭州310005

出　　处：《中华医院感染学杂志》2012年第8期1600-1601,共2页Chinese Journal of Nosocomiology

摘　　要：目的对骨科患者感染的危险因素进行调查,研究预防感染的控制措施,以降低医院感染率。方法对医院骨科2009年8月-2011年6月2226例住院患者的病历资料进行回顾性调查分析。结果 2226例骨科住院患者中发生医院感染81例,感染率为3.64%;最主要的感染部位为泌尿系统,占64.20%,其次是手术切口、上呼吸道、皮肤及软组织、下呼吸道;主要的危险因素为抗菌药物使用、侵入性操作、原发疾病;81例患者中经手术治疗的71例,占87.65%;留置尿管63例,占77.78%,治疗中经验使用抗菌药物72例,占88.89%,使用>2种抗菌药物46例,占56.79%,是主要的危险因素之一;从培养的菌株显示,以革兰阴性菌为主,共40株,占49.38%,革兰阳性菌32株,占39.51%,真菌9株,占11.11%。结论骨科患者感染的危险因素是多方面的,对骨科患者的治疗应严格按照岗位标准操作规程进行操作,对各环节治疗均进行严格的质量控制,合理使用抗菌药物,以降低医院感染的发生率。OBJECTIVE To investigate the risk factors for infections in orthopedic patients and study the control measures for infection control so as to reduce hospital rates.METHODS The clinical data of 2226 cases of hospitalized orthopedic patients in hospital from Aug 2009 to Jun 2011 were retrospectively analyzed.RESULTS Nosocomial infections occurred in 81 of 2226 orthopedic inpatients with the infection rate of 3.64%;the predominant infected site was urinary tract,accounting for 64.20%,followed by surgical incision,upper respiratory tract,skin and soft tissues,and respiratory tract;the main risk factors included the use of antibiotics,invasive procedures,and the primary disease;totally 71 of 81 patients were by surgical treatment,accounting for 87.65%;indwelling catheterization was in 63 cases,accounting for 77.78%,the empirical use of antibiotics for treatment was in 72 patients,accounting for 88.89%;the use of two or more antibiotics was in 46 cases,accounting for 56.79%,which was one of the major risk factors;the culture results indicated that gram-negative bacteria were the predominant isolates,accounting for 49.38%（40 strains）,gram-positive bacteria accounted for 39.51%（32 strains）,and that fungi accounted for 11.11%（9 strains）.CONCLUSION There are many risk factors for infections in orthopedic patients,therefore,the treatment of orthopedic patients should be strict in accordance with standard operation procedures for positions;the incidence of nosocomial infections can be reduced through strict quality control of various steps and reasonable use of antibiotics.

关 键 词：骨科患者 医院感染 危险因素 

分 类 号：R181.32[医药卫生—流行病学]