急诊下肢动脉栓塞切开取栓术患者切口感染相关因素调查  

The analysis of correlative factors to incision infection in treatment of acute lower extremity arterial thrombosis

作　　者：刘苏健[1] 银彩霞[2] 申庆民 吴继东[3] 

机构地区：[1]航天中心医院外周血管介入科,北京100049 [2]解放军总医院麻醉手术中心,北京100853 [3]北京航天总医院血管外科,北京100076

出　　处：《中华医院感染学杂志》2014年第7期1739-1741,共3页Chinese Journal of Nosocomiology

基　　金：北京市研发攻关基金项目(Z080507030808010)

摘　　要：目的探讨急诊下肢动脉栓塞切开取栓术后手术切口感染的预防和治疗措施,为临床治疗提供参考依据。方法回顾性分析2010年1月-2012年12月医院血管外科收治65例下肢动脉急性栓塞患者的手术时机、手术时间和抗菌药物应用与切口感染特点,采用SPSS13.0统计软件对所有数据进行分析。结果 65例下肢动脉栓塞患者均行急诊下肢动脉切开取栓术,术后切口感染4例次,感染率6.15%,分别为大肠埃希菌感染4例36.4%,奇异变形菌感染2例18.1%,金黄色葡萄球菌感染3例27.3%,副流感嗜血菌感染1例9.1%,阴沟肠杆菌感染1例9.1%;急诊手术、高龄、体质量指数高、患有糖尿病、合并其他脏器疾病为切口感染的相关因素。结论完善术前准备、严格无菌操作、术后使用抗凝药物、合理使用抗菌药物是预防下肢动脉栓塞切开取栓术后手术切口感染的重要措施。OBJECTIVE To discuss the related factors and the prevention of incision infection in treatment of acute arterial thrombosis ,so as to provide reference to the clinic .METHODS A retrospective analysis on the timing of surgery ,duration of surgery ,antimicrobial application and incision infection characteristics was taken towards 65 patients with acute lower extremity arterial thrombosis admitted to vascular surgery from Jan .2010 to Dec .2012 , and SPSS13 .0 software was used for analyzing all the data .RESULTS All 65 cases with acute lower extremity arterial thrombosis were received the artery of lower extremity incision embolectomy ,and 4 cases were infected , accounting for 6 .15% ,among which 4 cases caused by Escherichia coli （36 .4% ） ,2 cases by Proteus mirabilis （18 .1% ） ,3 cases by Staphylococcus aureus （27 .3% ） ,1 case by Haemophilus inf luenae （9 .1% ） and 1 case by Enterobacter cloacae （9 .1% ） . The influence factors of surgery site infection related to emergency operation , advanced age ,higher BMI ,glycuresis ,and combined with underlying diseases .CONCLUSION The preparation before the surgery should be improved ,the aseptic technique should be strengthened ,the anticoagulant should be used after surgery and antibacterial agents should be used rationally .And these are the important measures to prevent the surgery incision infection after artery of lower extremity incision embolectomy .

关 键 词：切口感染 动脉栓塞 取栓术 危险因素 

分 类 号：R619.3[医药卫生—外科学]