口腔颌面部游离组织皮瓣手术部位感染的病原学诊断及治疗  

Etiological diagnosis and treatment of surgical site infections after free tissue flap surgery in oromaxillo-facial region

作　　者：周晓丽[1] 郭福君[1] 李宏[1] 

机构地区：[1]河南科技大学第一附属医院口腔科,河南洛阳471003

出　　处：《中华医院感染学杂志》2014年第19期4859-4860,4863,共3页Chinese Journal of Nosocomiology

基　　金：洛阳市卫生局中青年扶持基金资助项目(LS-2010B008)

摘　　要：目的观察口腔颌面部游离组织皮瓣手术患者手术部位感染(SSI)的病原学分析,以期提高临床诊治水平。方法选择2005年3月-2013年3月收治的152例口腔颌面部损伤需要接受游离组织皮瓣移植修复手术患者,观察患者SSI发生率,并统计发生SSI的相关因素以及病原学分析,数据均采用SPSS16.0软件进行统计分析和处理。结果 152例口腔颌面部游离组织皮瓣手术患者发生SSI 27例,发生率为17.76%;口腔颌面部游离组织皮瓣手术患者发生SSI的相关因素,与患者术前的白细胞计数以及术前抗菌药物使用时间有关,差异有统计学意义(P<0.05);SSI病原菌以革兰阴性菌为主占62.96%、革兰阳性菌为29.63%、真菌为7.41%。结论口腔颌面部游离组织皮瓣手术患者发生SSI的相关因素与术前白细胞计数以及抗菌药物使用时间有关,因此应加强患者术前预防性抗菌药物使用,加强术后的随访和干预措施,有效降低SSI的发生。OBJECTIVE To etiologically analyze surgical site infections（SSI）after free tissue flap surgery in the oromaxillo-facial region so as to improve clinical diagnosis and treatment.METHODS A retrospective analysis was conducted on 152 patients who received free tissue flap surgery for oromaxillo-facial injuries from Mar.2005 to Mar.2013.Patients were observed for the incidence of SSI,the related factors for SSI were investigated for etiological analysis and all data were statistically analyzed and processed with the SPSS 16.0software.RESULTS There were 27 cases of SSI in the 152 patients undergoing free tissue flap surgery in the oromaxillo-facial region,the prevalence was 17.7%.Factors for SSI after free tissue flap surgery in the oromaxillo-facial region were related to the patient′s white blood cell count before surgery,and preoperative use of antibiotics,with significant differences（P〈0.05）.The pathogens for SSI were mainly gram-negative bacteria accounting for 62.96%,grampositive bacteria 29.63%,and fungi 7.41%.CONCLUSION As the related factors for SSI after free tissue flap surgery in the oromaxillo-facial region included postoperative white blood cell count and time for preoperative use of antibiotics,there is need to strengthen the preoperative use of prophylactic antibiotics,postoperative follow-ups and interventions to reduce the incidence of SSI.

关 键 词：口腔颌面部 游离组织皮瓣手术 手术部位感染 病原学 

分 类 号：R619.3[医药卫生—外科学]