重度开放性下肢骨折感染的治疗  

Treatment of infections in patients with severe open lower extremity fractures

作　　者：占允中[1] 叶舟[1] 占蓓雷[1] 

机构地区：[1]衢州市人民医院骨科,浙江衢州324000

出　　处：《中华医院感染学杂志》2013年第19期4712-4713,共2页Chinese Journal of Nosocomiology

基　　金：吴阶平医学基金(320.7650.12636)

摘　　要：目的探讨重度开放性骨折患者感染的多阶段治疗措施及其结果,以期为今后临床治疗重度开放性骨折提供参考和借鉴。方法回顾性收集和整理2007年5月-2011年10月医院收治的44例重度开放性骨折的创口感染患者特点、分阶段治疗及预后,利用软件SPSS13.0进行统计描述和统计分析。结果 44例重度开放性骨折创口感染患者检出的前3位病原菌分别为铜绿假单胞菌、金黄色葡萄球菌和鲍氏不动杆菌,分别占36.7%、26.8%和22.5%;经清创术和感染控制治疗后,44例患者均成功完成皮瓣移植,最终38例患者骨骼愈合、6例患者出现骨不连,骨骼愈合率>80.0%。结论严格清创、合理使用抗菌药物、延后创面闭合的多阶段处理方式是治疗已感染的重度开放性骨折的有效手段。OBJECTIVE To examine the outcome of multistage treatment of infected severe open lower extremity fractures so as to provide basis for future clinical treatment of severe open lower extremity fractures. METHODS Characteristics of wound infections, multistage treatment process, and prognosis of 44 severe open lower extremity fractures patients with wound infections who were treated were treated in the hospital from may 2007 to Oct 2011 were collected and arranged retrospectively, and all the statistical description and analysis were completed by software SPSS 13.0. RESULTS The first three pathogens of 44 patients with infected severe open lower extremity fractures were Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter baumannii, accounting for 36.7 %, 26.8 % and 22.5% respectively. After strict debridement and antibiotics treatment, all the 44 patients have been successfully completed flap transplantation, at last 38 patients showed bone union, while 6 patients had bone ununion, the rate of bone union was over 80.0 % after multistage treatment. CONCLUSION The multistage treatment, including strict debridement, rational use of antibiotics and delayed wound coverage, is an effective therapy for the severe open lower extremity fractures patients with infections.

关 键 词：下肢开放性骨折 创口感染 疗效 

分 类 号：R683.42[医药卫生—骨科学]