旋耕机造成下肢毁损伤的特点及感染控制体会  

The Characteristics of Lower Limb Damage Caused by Rotary Tiller and the Experience of Infection Control

作　　者：郭孝菊 李军 万值颖 姚玲 GUO Xiao-ju;LI Jun;WAN Zhi-ying;YAO Ling(Dept.of Orthopedics,920 Hospital of Joint Service Support Forces,Kunming Yunnan 650100,China)

机构地区：[1]解放军联勤保障部队第九二○医院骨科,云南昆明650100

出　　处：《昆明医科大学学报》2020年第10期129-133,共5页Journal of Kunming Medical University

基　　金：云南省卫健委临床中心建设基金资助项目(ZX20191001)。

摘　　要：目的探讨旋耕机造成下肢毁损伤的特点、探索早期预防及控制感染的策略,提高患者的治愈率及保肢率。方法回顾性分析联勤保障部队第九二○医院2015年4月至2019年12月旋耕机损伤的病例数,统计肢体损伤的Gustilo分型、伤口细菌培养结果以及所选用的敏感抗生素。结果结合纳入及排除标准共纳入研究98例,其中GustiloⅢ型占总患者的93.09%,98例病人中67例培养出细菌,其中阳性菌33株,阴性菌34株。敏感抗生素以头孢二、三代及氨基糖苷类为主。结论旋耕机多造成下肢毁损伤,感染重难以控制,救治不当轻则截肢,重则危及生命。需及时反复多次清创去除感染灶,根据术中细菌培养调整敏感抗生素。定期复查感染指标,及时调整用药方案。Objective To study the characteristics of lower limb damage caused by rotary tiller,explore the strategies of early prevention,controlling of infection, and improve the cure rate and limb saving rate of patients.Methods Retrospective analysis of the number of cases of rotary tiller injuries was conducted in the 920 Hospital of the Joint Logistic Support Force from April 2015 to December 2019. The Gustilo typing,bacterial results,and sensitive antibiotics selected were used in the limb injury. Result Combined into and exclusion criteria were included in the study of 98 cases,including Gustilo Ⅲ type accounted for 93.09% of the total patients. Among 98 patients, 67 cases had cultured bacteria,including 33 positive bacteria and 34 negative bacteria. The antibiotics mostly choose the second and third generation cephalosporins and aminoglycosides. Conclusion Rotary tillers often cause damage to the lower limbs, the infection is difficult to control, improper treatmer can result in amputation, and serious life-threatening. Timely and repeated debridement is necessany to remove the infection,adjust sensitive antibiotics according to the intraoperative bacterial culture. Also, it is necessar to review the infection index regularly and adjust the medication plan in time.

关 键 词：旋耕机 感染特点 感染控制 保肢 

分 类 号：R683[医药卫生—骨科学]