2017年度北京市某三甲医院创面修复专科住院病例回顾分析  

Retrospective analysis of hospitalized cases in wound repair center from a tertiary hospital at Beijing in 2017

作　　者：杨义 郝岱峰[2] 褚万立[2] 冯光[2] 张海军[2] Yang Yi;Hao Daifeng;Chu Wanli;Feng Guang;Zhang Haijun(People′s Liberation Army Medical College,Beijing 100853;Department of Burns and Plastic Surgery,Wound Repair Center,Fourth Medical Center of PLA General Hospital,Beijing 100048,China)

机构地区：[1]解放军医学院,北京100853 [2]解放军总医院第四医学中心烧伤整形暨创面修复中心,北京100048

出　　处：《中华损伤与修复杂志（电子版）》2019年第5期344-349,共6页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：北京市自然科学基金面上项目(7182160)

摘　　要：目的调查北京市某区三甲医院创面修复专科皮肤软组织损伤住院病例,探讨其流行病学特征以及相关诊疗信息。方法回顾性分析解放军总医院第四医学中心烧伤整形暨创面修复中心2017年1月1日至12月31日收治的全部住院患者资料。统计患者基本信息,创面的类型、部位与创面微生物培养结果,治疗方式和结果,以及卫生经济学信息。描述住院患者流行病学特征,分别比较性别、病程、类型、治疗方式因素对创面细菌感染、疗效、住院时间及住院费用的影响。数据行单因素方差分析、Wilcoxon秩和检验、Kruskal-Wallis H检验、χ^2检验与H检验。结果最终纳入研究639例患者,男420例,女219例。(1)患者平均年龄为57.00(43.00~67.00)岁,女性患者平均年龄大于男性患者,差异有统计学意义(Z=-2.605,P<0.05);(2)290例患者合并有慢性基础性疾病,最常见的疾病依次为糖尿病、高血压、冠状动脉粥样硬化性心脏病;(3)慢性皮肤软组织损伤患者数量多于急性皮肤软组织损伤患者;(4)最常见的创面类型依次为术后难愈性伤口、糖尿病足部溃疡、压力性损伤与皮肤软组织感染,最常见的创面部位依次为足部、下肢及胸部;(5)创面细菌学检查显示革兰氏阴性菌构成比最高(57.61%),常见细菌依次为金黄色葡萄球菌、大肠杆菌、肺炎克雷伯氏菌、奇异变形杆菌、铜绿假单胞菌;(6)136例患者行单纯换药治疗,118例行单纯持续负压封闭引流治疗,385例行手术治疗,其中130例行多次手术治疗。治愈282例,好转313例,未愈39例,死亡5例;(7)人均花费34 354.15(16 449.72~75 018.24)元;人均住院时间21.00(11.00~40.00)d。按创面类型分类,免疫疾病性皮肤溃疡患者的住院费用和时间最高,肥厚性瘢痕患者的住院费用和时间最低。按费用类型划分,工伤保险患者的住院费用和时间最高,自费医疗患者的住院费用和时间最低。结论患者多为中�Objective To retrospectively investigate the epidemiological characteristics and related medical information of hospitalized cases of skin and soft tissue injury in wound repair center from a tertiary hospital in Beijing.Methods All data of hospitalized cases from January 1,2017 to December 31 in the Department of Burns and Plastic Surgery,Wound Repair Center,Fourth Medical Center of Chinese PLA General Hospital were collected and analyzed.The information included patients basic data,wound types,locations and microbiology information,therapies,outcomes,and health economics information.The epidemiological features of hospitalized patients was described,and the effects of gender,course of wound,wound type,treatment on wound infection,curative effects,hospitalization time and hospitalization expenses were compared.Data were processed with one-way analysis of variance,Wilcoxon rank test,Kruskal-Wallis H test,chi-square test and H test.Results Six hundred and thirty-nine patients were finally included in this study,including 420 males and 219 females.(1)The mean age of patients was 57.00(43.00-67.00)years old,the mean age of female was greater than that of male,the difference was statistically significant(Z=-2.605,P<0,05).(2)Two hundred and ninty patients with chronic basic diseases,the most common diseases were diabetes mellitus,hypertension,coronary atherosclerotic heart disease.(3)The number of patients with chronic skin and soft tissue injuries was more than acute skin and soft tissue injuries.(4)The most common causes were postoperative non-healing wounds,diabetic foot ulcer,pressure injury and soft tissue infections,the most common locations were the feet,lower extremities and chests.(5)Bacterial examination of the wound showed Gram-negative bacteria composition ratio was the highest(57.61%).Common bacteria were Staphylococcus aureus,Escherichia coli,Klebsiella pneumoniae,Proteus mirabilis,Pseudomonas aeruginosa.(6)One hundred and thirty-six patients underwent simple dressing treatment,118 underwent simple conti

关 键 词：软组织损伤 感染 伤口愈合 流行病学 住院患者 分析 

分 类 号：R47[医药卫生—护理学]