骨科植入术后患者医院感染临床特征与实施流程化管理的控制研究  

Clinical characteristics of postoperative nosocomial infections in patients undergoing orthopedic implants surgery and effect of process management

作　　者：杨楠[1] 马雄心[1] 杨文选[1] 吴睿[2] 杨军红[2] 

机构地区：[1]郑州大学第五附属医院手术部,河南郑州450000 [2]郑州大学第五附属医院感染管理办公室,河南郑州450000

出　　处：《中华医院感染学杂志》2015年第23期5444-5446,共3页Chinese Journal of Nosocomiology

基　　金：河南省自然科学基金资助项目(0411044100)

摘　　要：目的探讨骨科植入术后患者医院感染临床特征及实施流程化管理的控制作用,为降低医院感染率提供借鉴。方法将2014年1月-2015年6月在医院手术室行骨科植入物手术的560例患者随机分为管理组280例和对照组280例,对照组采用常规管理制度,管理组在对照组基础上实施流程化管理;比较两组患者术后医院感染率及病原菌分布,数据采用SPSS19.0软件进行统计分析。结果 560例患者共计9例发生医院感染,医院感染率1.6%,管理组感染1例感染率为0.4%、对照组8例为2.9%,管理组医院感染率显著低于对照组,差异有统计学意义(P<0.05);共分离出17株病原菌,以革兰阳性菌为主,共9株占52.9%。结论骨科植术后医院感染病原菌主要为革兰阳性菌,优化手术室管理能够降低医院感染率,提升感染管理质量。OBJECTIVE To explore the clinical characteristics of postoperative nosocomial infections in the patients undergoing orthopedic implants surgery and observe the effect of the process management so as to reduce the inci- dence ＇of the nosocomial infections. METHODS A total of 560 patients who underwent orthopedic implants surgery in the operating rooms from Jan 2014 to Jun 2015 were enrolled in the study and randomly divided into the man- agement group with 280 cases and the control group with 280 cases. The control group was treated with conven- tional management system, while the management group was treated with process management on the basis of the control group. The incidence of postoperative nosocomial infections and distribution of pathogens were observed and compared between the two groups, and the statistical analysis was performed with the use of SPSS19.0 soft- ware. RESULTS Of 560 patients, 9 cases had nosocomial infection with the infection rate of 1.6%, including 1 case in the management group with the infection rate of 0.4% and 8 cases in the control group with the infection rate of 2.9% ; the incidence of nosocomial infections of the management group was significantly lower than that of the control group （P〈0.05）. Totally 17 strains of pathogens were isolated, of which 52.9% （9 strains ） were gram-positive bacteria. CONCLUSION The gram-positive bacteria are dominant among the pathogens causing the postoperative nosocomial infections in the patients undergoing orthopedic implants surgery. The optimized man- agement of the operating rooms can reduce the incidences of the nosocomial infections and improve the quality of management of the infections.

关 键 词：骨科植入物 医院感染 流程化管理 临床特征 

分 类 号：R619.3[医药卫生—外科学]