高原地区老年慢性难愈合创面患者流行病学调查分析  

Epidemiological investigation and analysis of elderly patients with chronic refractory wounds in plateau area

作　　者：祁万乐[1] 卓么加[1] 田琰[1] 达娃卓玛[1] 马子英[1] 安亚南 包俊杰[1] Qi Wanle;Zhuo Mejia;Tian Yan;Dawa Zhuoma;Ma Ziying;An Yanan;Bao Junjie(Department of Burns and Plastic Surgery,Qinghai Provincial People′s Hospital,Qinghai 810001,China)

机构地区：[1]青海省人民医院烧伤整形科,西宁810001

出　　处：《中华损伤与修复杂志（电子版）》2021年第1期44-49,共6页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的分析高原地区老年慢性难愈合创面患者流行病学特征,分析针对性治疗措施对其临床预后的影响。方法选择2019年10月至2020年10月就诊于青海省人民医院烧伤整形科的老年慢性难愈合创面患者共106例,收集患者一般资料,包括:性别、年龄、居住地区、是否有基础疾病;分析患者创面形成原因;比较不同创面形成部位患者占比情况;分析其创面检出病原菌情况;对比采用不同治疗方式患者的治疗有效率、住院时间及医疗费用;比较不同年龄段患者临床转归情况。数据比较采用单因素方差分析、t检验和χ^(2)检验。结果本次纳入的老年慢性难愈合创面患者中,男性占66.04%,女性占33.96%,男性患者多于女性患者;其中70~80岁患者最多,占44.34%,其次为60~70岁,占36.79%,80岁以上患者数量最少,占18.87%;多数患者来自于城市地区,且大部分患有高血压、糖尿病、感染等基础疾病;病因分析可知,高原地区老年慢性难愈合创面患者中糖尿病足为首要病因,占比51.9%,第2病因是压疮(17.9%),第3、4病因是手术伤口感染(10.4%)及创伤性溃疡(9.4%),而静脉性溃疡和动脉性溃疡所占比例最小,分别为6.6%和3.8%;慢性难愈合创面主要位于下肢,其次为腰背骶尾部和上肢。创面共检出病原菌106株,以革兰氏阳性球菌为主,占61.32%,其中以金黄色葡萄球菌为主(42.45%),其次为表皮葡萄球菌(10.38%),其他阳性球菌占比均不足10.00%;革兰氏阴性杆菌38株(35.85%),其中大肠杆菌最多(11.32%),其次为肺炎克雷伯菌、阴沟肠杆菌及铜绿假单胞菌;检出真菌3株(2.83%)。不同治疗方式患者的治疗有效率比较,差异有统计学意义(χ^(2)=9.602,P<0.05),手术+补充治疗患者治疗有效率显著高于手术治疗患者,保守+补充治疗患者治疗有效率显著高于仅接受保守治疗的患者,差异均有统计学意义(χ^(2)=4.367、3.876,P<0.05);不同治疗方式患者的住院时间、�Objective To analyze the epidemiological characteristics of elderly patients with chronic refractory wound in plateau area,and analyze the impact of targeted treatment measures on the clinical prognosis.Methods A total of 106 elderly patients with chronic refractory wounds were selected from October 2019 to October 2020 in the Department of Burns and Plastic Surgery,Qinghai Provincial People′s Hospital.The general data of the patients were collected,including gender,age,residential area,and whether there were basic diseases;the causes of wound formation were analyzed;the proportion of patients with different wound formation sites was compared;and the detection of pathogenic bacteria on the wounds were analyzed.The effective rate,length of stay and medical expenses of patients with different treatment methods were investigated,and the clinical outcomes of patients with different ages were compared.Data were compared by one-way ANOVA,t test and chi-square test.Results Among the elderly patients with chronic refractory wounds included in this study,66.04%were male and 33.96%were female.The number of male patients was more than that of female patients.The number of patients aged 70 to 80 years old was the most,accounting for 44.34%,followed by 60 to 70 years old,accounting for 36.79%,and the number of patients over 80 years old was the least,accounting for 18.87%.Most of the patients come from urban areas,and most of them suffer from hypertension,diabetes,infection and other basic diseases.Etiological analysis showed that diabetic foot was the primary cause of elderly patients with chronic refractory wounds in plateau area,accounting for 51.9%,the second cause was pressure ulcer(17.9%),the third and the fourth cause were surgical wound infection(10.4%)and traumatic ulcer(9.4%),while venous and arterial ulcer accounted for the smallest proportion,accounting for 6.6%and 3.8%respectively;chronic refractory wounds were mainly located in the lower limbs,followed by lumbodorsal sacrococcygeal and upper limbs.A total of 1

关 键 词：老年人 伤口愈合 流行病学 高原 慢性难愈合创面 

分 类 号：R181.3[医药卫生—流行病学] R632[医药卫生—公共卫生与预防医学]