胫骨干骨折患者内固定术后感染的调查  

Investigation of postoperative infections in tibia infraction

作　　者：陈洪娇[1] 程少文[1] 符紫云 

机构地区：[1]海南医学院附属医院急诊创伤外科,海南海口570102

出　　处：《中华医院感染学杂志》2014年第16期4066-4068,共3页Chinese Journal of Nosocomiology

基　　金：广东省科技计划基金资助项目(2007B031502002)

摘　　要：目的分析胫骨干骨折患者行内固定术后的感染情况,探讨其干预措施,为临床治疗提供参考依据。方法将医院2011年5月-2013年5月胫骨干骨折行内固定术后发生感染的患者52例,随机分为观察组和对照组,各26例;对照组行常规护理,观察组给予引流护理、功能锻炼、健康指导等干预措施,采用SPSS 15.0软件分析。结果 52例患者送检标本培养出病原菌42株,均为单一菌株感染,其中革兰阴性杆菌25株,革兰阳性球菌17株;发生感染的原因有清创不彻底16例、止血不充分13例、固定不牢固10例、无菌术操作不严格6例、抗菌药物使用不当4例、骨折端缺乏软组织覆盖3例等;经治疗护理两组患者的感染均得到有效控制,两组患者的拔管时间和住院时间比较差异有统计学意义(P<0.05)。结论胫骨干行内固定术后发生感染主要由于清创不彻底或未严格地按照无菌原则执行操作,给予及时的治疗和精心的护理能有效减少患者拔管及住院时间。OBJECTIVE To analyze infection status after internal fixation for patients with tibia infraction and discuss the nursing intervention measures for reference for clinical treatment.METHODS Totally 52 patients with infections after internal fixation for tibia infraction from May 2011 to May 2013 were included in this research.The patients were randomly divided into the observation group and the control group（n=26 in each group）.The control group received routine nursing care and the observation group was given with nursing intervention measures including drainage guidance and mental nursing,functional exercise,and health care.Data were analyzed by SPSS 15.0.RESULTS The 52 cases were detected with 42 pathogens and the infected cases were all single strain infection,the pathogens included 25 gram negative bacilli and 17 gram positive cocci.The causes for infections included incomplete debridement（16cases）,inadequate bleeding（13cases）,weak fixation（10cases）,non-strict aseptic operation（6cases）,improper use of antibiotics（4cases）,lack of soft tissue coverage on fracture end（3cases）.Infections were effectively controlled in both groups.Difference in the exudation time and hospital stays between the two groups of patients was significant（P0.05）.CONCLUSION Postoperative infection in tibia infraction was mainly due to inadequate debridement or preformation in non-strict accordance with the principle of aseptic operation and giving timely treatment and careful nursing can effectively reduce extubation and hospitalization time for patients.

关 键 词：胫骨干 内固定 感染 干预措施 

分 类 号：R619.3[医药卫生—外科学]