开放性骨折患者医院感染临床分析及预防措施  

Clinical analysis of nosocomial infections in patients with open fracture and prevention measures

作　　者：王韬[1] 晏新[1] 扶世杰[1] 曾胜强[1] 龙彦[1] 

机构地区：[1]泸州医学院附属中医院急诊科,四川泸州646000

出　　处：《中华医院感染学杂志》2015年第10期2291-2293,共3页Chinese Journal of Nosocomiology

基　　金：四川省卫生厅科研基金资助项目(130296)

摘　　要：目的对开放性骨折患者医院感染的病原菌分布及危险因素进行分析,为临床降低医院感染的发生提供参考。方法选取2012年1月-2014年6月入院的2 000例开放性骨折患者为研究对象,对其中发生医院感染患者的临床资料进行回顾性分析,研究患者感染类型、感染病原菌分布及感染的危险因素;采用SPSS17.0软件进行统计分析。结果 2 000例开放性骨折患者中70例发生医院感染,感染率为3.50%;主要感染类型:骨髓炎25例占35.71%、血气胸伴创伤性肺部感染16例占22.86%、颌面部创伤后颅内感染14例占22.86%、腹部创伤后腹膜炎11例占15.71%;开放性骨折患者主要病原菌为革兰阴性菌41例占58.57%、革兰阳性菌25例占35.72%、真菌4例占5.71%;住院时间、病程、骨折部位、骨折损伤程度是开放性骨折患者医院感染相关因素,差异有统计学意义(P<0.05)。结论开放性骨折后医院感染进行临床特点和感染因素分析,为开放性骨折患者预防医院感染提供理论依据,在临床上具有重要意义。OBJECTIVE To investigate the distribution of pathogens causing nosocomial infections in the open frac‐ture patients and observe the risk factors so as to provide guidance for reduction of incidence of nosocomial infec‐tions .METHODS A total of 2 000 open fracture patients who were admitted to the hospital from Jan 2012 to Jun 2014 were recruited as the study objects ,the clinical data of the patients with nosocomial infections were retro‐spectively analyzed ,the types of infections ,distribution of pathogens ,and risk factors for the infections were ob‐served ,and the statistical analysis was performed with the use of SPSS17 .0 software .RESULTS The nosocomial infections occurred in 70 （3 .50% ） of 2 000 open fracture patients ,of whom 25 （35 .71% ） cases had osteomyeli‐tis ,16 （22 .86% ） had hemopneumothorax complicated with traumatic wet lung pulmonary infections , 14 （22 .86% ） had intracranial infections after maxillofacial trauma ,and 11 （15 .71% ） had peritonitis after abdominal trauma .The gram‐negative bacteria were dominant among the pathogens isolated from the open fracture patients , accounting for 58 .57% （41 cases） ,the gram‐positive bacteria accounted for 35 .72% （25 cases） ,and the fungi ac‐counted for 5 .71% （4 cases） .The related factors for the nosocomial infections in the open fracture patients includ‐ed the length of hospital stay ,disease course ,fracture sites ,and degree of fracture ,with statistical significance （P〈0 .05） .CONCLUSION It is of great significance to analyze the clinical characteristics of the nosocomial infec‐tions in the open fracture patients so as to provide theoretical basis for prevention of the nosocomial infections in the open fracture patients .

关 键 词：开放性骨折 医院感染 预防措施 

分 类 号：R181.32[医药卫生—流行病学]