开放性骨折患者创口感染临床特点及预防控制  

Clinical characteristics of open fracture patients with wound infections and prevention countermeasures

作　　者：汪珏 郑林峰 朱郎萍 沃金芳 

机构地区：[1]淳安新富中医骨伤医院骨科,浙江淳安县311700 [2]浙江大学医学院临床医学系,浙江杭州310000

出　　处：《中华医院感染学杂志》2014年第22期5592-5594,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生研究基金资助项目(2012WKC028)

摘　　要：目的探讨开放性骨折患者创口感染的临床特点、危险因素及预防控制对策,为早期预防和控制创口感染提供科学依据。方法选择骨科2006年6月-2013年12月750例开放性骨折患者发生创口感染135例的临床资料,对其进行回顾性调查与分析,探讨创口感染的临床特点及危险因素,总结预防控制对策。结果 750例开放性骨折患者发生创口感染135例,感染率为18.00%;135例创口感染患者送检标本共检出病原菌103株,革兰阴性杆菌61株占59.22%,主要为铜绿假单胞菌21株、大肠埃希菌18株、肺炎克雷伯菌12株;革兰阳性球菌37株占35.92%,主要为金黄色葡萄球菌23株、凝固酶阴性葡萄球菌9株;真菌5株占4.86%,主要为白色假丝酵母菌;开放性骨折创口感染的危险因素与性别、年龄差异无统计学意义;与骨折损伤程度、受伤至入院手术开始间隔时间、骨折部位、手术时间差异有统计学意义(P<0.05)。结论开放性骨折患者创口感染与骨折损伤程度、受伤至入院手术开始间隔时间、骨折部位、手术时间等因素有关,根据患者的临床特点,并针对危险因素给予相应的预防控制对策,对降低开放性骨折患者创口感染有重要的意义。OBJECTIVE To explore the clinical characteristics of the open fracture patients with wound infections , analyze the risk factors ,and put forward prevention countermeasures so as to provide scientific basis for early pre‐vention and control of the wound infections .METHODS The clinical data were collected from 135 of 750 open frac‐ture patients who were complicated with wound infections and hospitalized the orthopedics department from Jun 2006 to Dec 2013 ,then a retrospective survey was conducted ,the clinical characteristics and the risk factors for the wound infections were observed ,and the prevention countermeasures were put forward .RESULTS Of the 750 open fracture patients ,the wound infections occurred in 135 cases with the infection rate of 18 .00% .A total of 103 strains of pathogens have been isolated from the submitted specimens obtained from the 135 patients with wound infections ,including 61 （59 .22% ） strains of gram‐negative bacilli ,37 （35 .92% ） strains of gram‐positive cocci ,and 5 （4 .86% ） strains of fungi ;the Pseudomonas aeruginosa （21 strains ） ,Escherichia coli （18 strains ） , and K lebsiella pneumoniae （12 strains ） were the predominant species of gram‐negative bacilli ;the Staphylococcus aureus （23 strains ） and coagulase‐negative Staphylococcus （9 strains） were dominant among the gram‐positive cocci ;the Candida albicans was the predominant species of fungi .There were no statistically significant differ‐ences in the risk factors for the wound infections between the open fracture patients with different genders and age;there was statistically significant difference in the degree of fracture ,interval from injury to start of surgery , fracture site ,or operation duration （P〈0 .05） .CONCLUSION The incidence of wound infections in the open frac‐ture patients is related to the degree of fracture ,interval from injury to start of surgery ,fracture site ,and opera‐tion duration ;it is of great significance in the reduction of inciden

关 键 词：开放性骨折 患者 创口感染 临床特点 预防控制 

分 类 号：R619.3[医药卫生—外科学]