高龄患者股骨转子间骨折动力髋螺钉固定术后院内感染情况研究  

Study on nosocomial infection of elderly patients with femoral fractures between rotor after dynamic hip screw fixation

作　　者：杨建义[1] 郭春[1] 太祖华 

机构地区：[1]云南省昆明市官渡区人民医院骨科,云南昆明650200

出　　处：《现代预防医学》2014年第21期4020-4022,共3页Modern Preventive Medicine

摘　　要：目的分析高龄患者股骨转子间骨折动力髋螺钉固定术后院内感染相关资料,探讨感染部位分布情况及菌群分布特征,为今后提高治疗效果、减少院内感染提供参考。方法回顾性收集2005年4月-2012年12月在我院接受股骨转子间骨折动力髋螺钉固定术的60岁以上高龄患者资料,获得髋螺钉固定术高龄患者628例,其中发生术后感染患者资料53例。通过患者术后症状以及痰液、尿液、血液等标本的细菌培养结果,分析经DHS治疗发生院内感染的高龄患者中,感染发生部位及菌群的分布情况。结果经动力髋螺钉固定术治疗后,高龄患者感染发生率为8.4%,发生感染的患者中,34.0%感染部位为上呼吸道,28.3%为手术切口,17.0%为下呼吸道,11.3%为泌尿道,胃肠道及皮肤软组织所占构成比较低,分别为5.7%及3.8%。53例发生院内感染的患者体液标本中,共检出69株病原菌,其中铜绿假单胞菌所占比例最高,为33.3%,其次为大肠埃希菌(占21.7%)及肺炎克雷伯菌(占15.9%),金黄色葡萄球菌及阴沟肠杆菌所占比例均为10.1%,真菌感染占8.7%。结论高龄患者较易发生术后院内感染,上呼吸道及手术切口是感染发生的常见部位,应针对高龄患者的生理特征加强术后护理及抗菌药合理应用,以避免感染的发生。Objective To analyze the data about nosocomial infection of elderly patients with femoral fractures between rotor after dynamic hip screw fixation, to explore the infection distribution and characteristics of flora distribution, for the future to offer reference to improve the effect of treatment and reduce the nosocomial infection. Methods Retrospectively collected data of patients over the age of 60 who with femoral fractures between rotor after dynamic hip screw fixation during April, 2005 - December 2012 in our hospital, got 628 cases with hip screw fixation, including data of 53 patients with postoperative infection. By patients＇ postoperative symptoms and germicuhure results of sputum, urine, blood and other specimens of, analyzed the DHS treatment of hospital infections occurred in older patients, location and the distribution of bacteria infection. Results After treatment with dynamic hip screw fixation, infection rate of in elderly patients was 8.4%, in which 34.0% were upper respiratory tract infection, 28.3% for incision infection, 17.0% for lower respiratory tract infection, 11.3% for the urinary tract infection, infections in gastrointestinal tract and skin soft tissue were low, at 5.7% and 3.8% respectively. In body fluid specimens from 53 cases of nosocomial infection patients, a total of 69 strains of pathogenic bacteria were detected with the highest proportion of pseudomonas aeruginosa, at 33.3%, followed by e. eoli （21.7%） and klebsiella pneumoniae （15.9%）, staphylococcus aureus and sewer proportion of e. coli were 10.1%, fungal infection accounted for 8.7%. Conclusion The aged patients are more prone to postoperative nosoeomial infection, upper respiratory tract and surgical incision infection are common parts, it should strengthen postoperative nursing and antibacterial reasonable application according to the physiological characteristics of elderly patients, in order to avoid infection.

关 键 词：高龄患者 股骨转子间骨折 动力髋螺钉 院内感染 

分 类 号：R68[医药卫生—骨科学]