骨科无菌手术感染危险因素调查分析与对策研究  

Risk factors and control measures of incision infections for orthopedic sterile operation

作　　者：高宝琴[1] 王丽娜[1] 杨彬霞[1] 杜学军[2] 朱玉花[3] 张永强[4] 

机构地区：[1]新乡医学院第一附属医院手术室,河南卫辉453100 [2]新乡医学院第一附属医院骨科,河南卫辉453100 [3]新乡医学院第一附属医院感染控制科,河南卫辉453100 [4]新乡医学院第一附属医院麻醉科,河南卫辉453100

出　　处：《中华医院感染学杂志》2013年第13期3155-3157,共3页Chinese Journal of Nosocomiology

摘　　要：目的调查与分析骨科无菌手术切口感染的危险因素,探讨控制骨科无菌手术切口感染的对策,为预防与控制骨科无菌手术切口感染提供依据。方法以骨科2009年1月-2011年12月收治入院并进行无菌手术的1378例患者为研究对象,按是否发生切口感染将其分为感染组与非感染组,比较两组在平均年龄、平均术前住院时间、平均手术持续时间等方面的差异,并对危险因素进行分析。结果 1378例骨科无菌手术患者中发生切口感染45例,感染率为3.27%;男性患者切口感染率为3.54%,女性患者感染率2.49%,两者差异无统计学意义;45例切口感染患者的平均年龄、平均术前住院天数及平均手术持续时间分别为(59.8±9.6)岁、(10.9±2.3)d、(6.2±1.4)h,均高于非感染组的(44.3±4.5)岁、(5.2±1.1)d、(2.3±0.6)h,差异均有统计学意义(P<0.05);在腰髋部及下肢行无菌手术的患者切口感染率为3.94%,颈肩部及上肢切口感染率为1.69%,两者差异有统计学意义(P<0.05);导致骨科无菌手术后切口感染的菌种主要为金黄色葡萄球菌、表皮葡萄球菌、假单胞菌属,分别占31.1%、26.7%、17.8%。结论重视易感人群、提高医护人员无菌操作意识、提高手术操作者技能、合理使用抗菌药物是降低骨科无菌手术切口感染率的重要措施。OBJECTIVE To investigate the risk factors of incision infection after orthopedic sterile operation and discuss the prevention and control measures so as to provide the basis for control of incision infections after the orthopedic sterile operation.METHODS The clinical data of 1378patients who underwent the orthopedic sterile operation in the hospital from Jan 2009to Dec 2011were analyzed retrospectively.According to the status of infections,the patients were divided into the infection group and the non-infection group,then the average age,average hospitalization duration,and average operation time were compared between the two groups,and the risk factors were analyzed.RESULTS Totally 45incision infection cases were reported from 1378cases and the incision infection rate was 3.27%.The incision infection rate of the male patients was 3.54%,2.49% of the female patients,the difference between the two was not statistically significant.The average age,average preoperative hospitalization duration,and average operation time of the infection group were respectively（59.8±9.6）years old,（10.9±2.3）days,and（6.2±1.4）hours,significantly higher than（44.3±4.5）years old,（5.2±1.1）days,and（2.3±0.6）hours,the difference was statistically significant（P〈0.05）.The incision infection rate of the patients who underwent the waist,hip or lower limbs orthopedics operation was 3.94%,significantly higher than 1.69% of the patients who underwent the neck,shoulder or upper limbs orthopedics operation,the difference was statistically significant（P〈0.05）.The species of pathogens causing the incision infections after the orthopedic sterile operations were Staphylococcus aureus,Staphylococcus epidermidis,and Pseudomonas,accounting for 31.1%,26.7%,and 17.8%,respectively.CONCLUSIONIt is necessary to pay attention to high-risk patients,improve asepsis consciousness of medical personnel,improve the operator＇s skills,and reasonably use the antibiotics so as to reduce the incidence of incision infections after th

关 键 词：骨科无菌手术 切口感染 危险因素 

分 类 号：R619.3[医药卫生—外科学]