骨科术后伤口感染的危险因素分析及干预对策  

Risk factors of wound infections after orthopaedic surgery and intervention measures

作　　者：刘素莲[1] 毕春晖[2] 王星[1] 

机构地区：[1]莱芜市人民医院骨一科,山东莱芜271100 [2]莱芜市人民医院介入科,山东莱芜271100

出　　处：《中华医院感染学杂志》2013年第15期3664-3665,3671,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析骨科术后伤口感染的危险因素,提出干预对策,降低感染率。方法回顾性分析2008年8月-2012年8月收治的骨科手术患者1680例的临床资料,对发生伤口感染的相关因素通过SPSS13.0统计软件进行单因素及多因素分析。结果 1680例骨科手术患者中共发生术后感染33例,感染率2.0%;单因素分析显示,高龄(>60岁)、有皮肤或黏膜糜烂、合并有糖尿病、长期使用广谱抗菌药物(≥15d)、滥用免疫抑制剂、长时间住院(>30d)为医院感染的危险因素;logistic分析显示,有皮肤或黏膜糜烂在诸多指标中影响最大(P=0.006),其余依次为合并有糖尿病(P=0.007)、长期使用广谱抗菌药物(P=0.024)、滥用免疫抑制剂(P=0.028)、高龄(P=0.030)、长时间住院(P=0.037)。结论骨科术后伤口感染与多种因素关系密切,临床上应注意针对性进行干预,提高手术疗效。OBJECTIVE To analyze t risk factors of wound infections after orthopaedic surgery and put forward interventions to reduce the infection rate. METHODS The clinical data of 1680 cases of patients who underwent orthopaedic surgery in recent years were retrospectively analyzed, then the univariate analysis and multivariate analysis were performed for predisposing factors of wound infections. RESULTS Of totally 1680 patients, the postoperative infections occurred in 33 cases with the infection rate of 2.0 %. The univariate analysis showed that the advanced age （more than 60 years old）, skin or mucous membrane erosion, diabetes, the long-term use of broad spectrum antibiotics （more than 15 d）, abuse of immune inhibitors, and long hospitalization duration （more than 30 d） were the risk factors of nosocomial infections~ while the logistic analysis indicated that the skin or mucous membrane erosion （P= 0. 006） was the most influential factor, followed by the complication of diabetes mellitus （P〈 0. 007）, the long-term use of broad spectrum antibiotics （P =0. 024）, abuse of immune inhibitors （P=0.028）, the advanced age （P=0.030）, and long length of hospital stay （P=0.037）. CONCLUSION The incidence of wound infections after the orthopaedic surgery is closely related to a variety of factors, and the hospi- tal should focus on the targeted interventions so as to improve the surgical efficacy.

关 键 词：骨科 伤口感染 LOGISTIC分析 干预对策 

分 类 号：R619.3[医药卫生—外科学]