开放性胫腓骨骨折感染的危险因素调查  

Risk factors for the infections during the treatment of the open fractures of the tibia and fibula

作　　者：徐必生 邓敏[2] 袁华兵[1] 孙文武[1] 杨萍[1] 

机构地区：[1]天门市第一人民医院院感科,天门市431700 [2]华中科技大学同济医学院附属协和医院院感科,武汉市430000

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第3期83-85,共3页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的分析胫腓骨骨折患者术后感染危险因素,为临床防治提供依据。方法选取2009年1月至2013年12月就诊于天门市第一人民医院的190例胫腓骨骨折患者进行回顾性分析,并对危险因素进行评估。结果 190例患者中发生感染27例,感染率为14.2%;共检出病原菌33株,其中革兰阳性菌占30.03%,革兰阴性菌占63.64%;高龄(>75岁)、遗留死腔、手术时间长(>3 h)、有植皮、合并糖尿病或多种并症等是术后感染危险因素(P均<0.05)。结论术中精细化操作,减少软组织剥离、消除死腔和控制血糖等并发症、并及时合理使用抗菌药物是治疗成功的关键。Objective To analyze the risk factors for the infection in patients with the tibia and fibula fractures, and to provide basis for effective prevention and treatment. Methods The clinical data of 190 patients with the tibia and fibula fractures treated in Tianmen the First People＇s Hospital from January 2009 to December 2013 were selected, retrospectively, then the risk factors of the infections in 27 patients were analyzed. Results The infections occurred in 27 cases with the infection rate of 14.2% （27/190）. A total of 33 bacterial strains were detected, among which, l0 （30.03%） strains were Gram-positive bacteria, and 21 （63.64%） strains were Gram-negative bacteria. The more than 75 years of age, left dead space, duration of surgery more 3 hour, skin grafting and concurrent diabetes or many complications were the risk factors of the infections of the open fractures. Conclusions The intraoperative serious and detailed operation, reduction the soft tissue damage, elimination dead space, effective control of such complications as blood sugar, and timely and reasonable of the antibiotic use are crucial to the success of treatment of the tibia and fibula fractures.

关 键 词：胫骨骨折 危险因素 流行病学 

分 类 号：R687.3[医药卫生—骨科学]