骨科手术患者切口感染监测结果分析  

Analysis on the Monitoring Results of Orthopedic Surgery Incision Infection

作　　者：向丽佳[1] 曾勇[1] 曹芳[1] 罗婷[1] 王敏[1] 郑晓红[1] 

机构地区：[1]成都市第二人民医院医院感染管理科,成都610021

出　　处：《华西医学》2015年第3期492-495,共4页West China Medical Journal

摘　　要：目的了解骨科手术切口部位医院感染现状,为进一步干预提供依据。方法采取前瞻性调查与回顾性调查相结合方式,对2012年1月-12月545例骨科手术患者切口手术部位发生医院感染情况进行统计分析。结果经过1年术后追踪观察,545例患者中发生手术部位医院感染10例,感染率1.83%。其中Ⅰ类切口手术感染率为0.46%,Ⅱ类切口手术感染率为5.13%,Ⅲ/Ⅳ类切口手术感染率12.12%,污染程度越高,感染率越高,趋势有统计学意义(χ2=28.273,P<0.001)。按不同手术危险指数分类,危险指数评分为1分者手术部位感染率为0.82%,2分者2.60%,3分者为18.75%,手术危险指数越高,感染率越高,趋势有统计学意义(χ2=12.916,P<0.001)。按不同手术时期分类,择期手术感染率为1.43%,急诊手术感染率为3.15%,急诊手术感染率高于择期手术,但差异无统计学意义(P>0.05)。结论骨科为医院感染手术部位感染高风险科室,手术切口分类和手术危险指数与医院感染发生率高低有统计学关联,为保障患者安全,减少医疗纠纷,应高度关注骨科手术术后感染情况。Objective To study the present situation of hospital orthopedic surgery incision infection, in order to provide the basis for further intervention. Methods Prospective investigation combined with retrospective investigation method was adopted in our study to perform a statistical analysis on orthopedic surgery incision infections among 545 patients in our hospital between January and December 2012. Results During the one year of follow-up, there were 10 cases of surgical incision infection among all the 545 patients, with an infection rate of 1.83%. The infection rate of class-Ⅰ incision was 0.46%, of class-Ⅱ was 5.13%, and of class-Ⅲ / Ⅳ was 12.12%, and the Cochrane-Armitage trend chi-square test showed signifficant trend among them（χ2=28.273, P 〈 0.001）. Based on dif erent operation risk index, patients with index 1, 2, 3 had a surgical site infection rate of 0.82%, 2.60%, and 18.75%, respectively. The higher the index, the higher the surgery incision infection rate, and the trend was statistically signifficant（χ2=12.916, P 〈 0.001）. The infection rate was 1.43% for elective surgical procedures, and was 3.15% for emergency surgery, but there was no signifficant dif erence（P 〉 0.05）. Conclusions Orthopedic surgery has a high-risk surgical site infection rate, and incision classiffication and surgical risk index have statistical correlation with the incidence of hospital infection. In order to ensure the security of patients and reduce medical disputes, we should pay close attention to orthopedic surgery infection.

关 键 词：医院感染 手术部位感染 骨科手术 

分 类 号：R687[医药卫生—骨科学]