肢体玉米脱粒机绞伤27例的早期术后感染特点及治疗策略分析  

Characteristics of early postoperative infections in 27 patients with limbs injuries caused by corn thresher and treatment strategies

作　　者：张鹏 肖滋润 马江敏 ZHANG Peng;XIAO Zi-run;MA Jiang-min(PLA 91 st Central Hospital,Jiaozuo,Henan 454000,China)

机构地区：[1]解放军第九十一中心医院医务处,河南焦作454000 [2]解放军第九十一中心医院骨科一区,河南焦作454000 [3]解放军第一五三中心医院口腔科,河南郑州450042

出　　处：《中华医院感染学杂志》2018年第17期2645-2648,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨玉米脱粒机导致肢体绞伤患者的早期术后感染特点,总结治疗策略,以期为此类型患者提供进一步的治疗参考。方法回顾性分析2015-2016年医院收治的27例玉米脱粒机肢体绞伤患者临床资料,总结手术与术后治疗方案,记录并统计患者的残疾率、术后感染率、病原菌类型及抗菌药物应用情况,对患者的术后感染情况与Gustilo分型、接诊时间、手术时间等数据进行相关分析。结果 27例患者中共有15例最终导致不同程度的肢体残疾,总致残率为55.56%;发生术后感染14例,总感染率为51.85%,其中铜绿假单胞菌是主要的致病菌;不同Gustilo分型患者术后感染率比较,差异有统计学意义(χ2=13.101,P=0.001);患者术后感染率与Gustilo分型存在正相关关系(ρ=0.645,P<0.001),与年龄、性别、接诊时间、手术时间均无相关性。结论玉米脱粒机致肢体绞伤的致残率及术后感染率高,铜绿假单胞菌为主要感染致病菌,对于GustiloⅢ型损伤的治疗策略应当结合患者损伤情况与医疗保障水平予以充分考虑。OBJECTIVE To explore the characteristics of early postoperative infections in patients with limb injuries caused by corn thresher and put forward the treatment strategies so as to provide guidance for further treatment.METHODS The clinical data of 27 patients with corn thresher-induced limb injuries who were treated in the hospital from 2015 to 2016 were retrospectively analyzed,the surgical and postoperative treatment programs were summarized,the disability rate,incidence of postoperative infection,species of pathogens and use of antibiotics were recorded and statistically analyzed.The correlation between the incidence of postoperative infection and the Gustilo type,time of clinical reception and operation duration was observed.RESULTS Of the 27 patients,15 had various degree of extremity disability,with the total disability rate 55.56%;totally 14 had postoperative infections,with the total infection rate 51.85%.Pseudomonasaeruginosa was the predominant species of pathogen.There was significant difference in the incidence of postoperative infection among the patients with different Gustilo types（χ^2=13.101,P=0.001）.The incidence of postoperative infection was positively corelated with the Gustilo type（ρ=0.645,P〈0.001）and was not associated with the age,gender,time of clinical reception or operation duration.CONCLUSIONThe disability rate and the incidence of postoperative infections are high in the patients with corn thresher-induced limbs injuries,the P.aeruginosa is dominant among the pathogens causing the infections.It is necessary to take into account the status of injuries combined with the level of medical care so as to put forward the treatment strategies for the patients with GustiloⅢinjury.

关 键 词：玉米脱粒机 术后感染 治疗策略 

分 类 号：R619[医药卫生—外科学]