四肢深度烧伤患者创面感染危险因素分析  

Analysis of Risk Factors of Wound Infection in Patients with Deep Burns of Extremities

作　　者：唐平 赵兆[1] 仲其飞 许怀刚 张建平 TANG Ping;ZHAO Zhao;ZHONG Qi-fei;XU Huai-gang;ZHANG Jian-ping(Department of Severe Medicine,Shuyang Hospital Affi liated to Nanjing University of Traditional Chinese Medicine,Shuyang 223600,Jiangsu,China;Department of Burn Plastic,Shuyang Hospital Affi liated to Nanjing University of Traditional Chinese Medicine,Shuyang 223600,Jiangsu,China)

机构地区：[1]南京中医药大学附属沭阳医院重症医学科,江苏沭阳223600 [2]南京中医药大学附属沭阳医院烧伤整形科,江苏沭阳223600

出　　处：《中国美容医学》2021年第11期26-29,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:分析四肢深度烧伤患者创面感染的危险因素。方法:选择2018年1月-2020年12月在南京中医药大学附属沭阳医院重症医学科接受治疗的73例四肢深度烧伤患者的病历资料进行回顾性分析。分析患者发生创面感染的情况。对创面感染的病原体培养结果进行描述。以患者是否发生创面感染进行分组,对比两组患者的资料,利用单因素分析与多因素分析的方法筛选四肢深度烧伤患者的创面发生感染的危险因素。结果:纳入研究的73例患者之中,有20例出现创面感染,创面感染率为27.40%。对20名出现创面感染的患者进行采样,共培养出33株病原体,其中革兰阳性菌17株,占51.52%,金黄色葡萄球菌12株,占36.36%。年龄、烧伤面积、烧伤深度、预防性抗生素使用时间、术后负压引流使用情况、手术时间长度,均成为四肢深度烧伤患者的创面发生感染的独立影响因素(P<0.05)。结论:四肢深度烧伤患者出现创面感染的风险相对较高,革兰阳性菌造成感染的可能性更大,若干因素均可以对该类患者发生创面感染的概率构成影响,医务人员可对其中具有可调控意义的因素进行人为干预,这对于改善患者的预后具有重要的意义。Objective To analyze the risk factors for wound infection in patients with deep burns of extremities. Methods The medical records of 73 patients with deep burns of extremities who were treated in the Department of Critical Care Medicine,Shuyang Hospital, Nanjing University of Traditional Chinese Medicine from January 2018 to December 2020 were selected for retrospective analysis. Analyze the wound infection of the patient. Describe the results of pathogen culture of wound infection.The patients were divided into groups according to whether they had wound infections, and the data of the two groups were compared, and the single factor analysis and multi-factor analysis were used to screen the risk factors of wound infections in patients with deep burns of extremities. Results Among the 73 patients included in the study, 20 patients developed wound infection, and the wound infection rate was 27.40%. A total of 33 pathogens were isolated from 20 patients with wound infection, including 17 strains of Gram-positive bacteria(51.52%) and 12 strains of Staphylococcus aureus(36.36%). Age, burn area, burn depth, prophylactic antibiotic use time, postoperative use of negative pressure drainage and operation time were all independent influencing factors of wound infection in patients with deep burn of extremities(P<0.05). Conclusion Patients with deep burns of limbs have a relatively high risk of wound infection, and Gram-positive bacteria are more likely to cause infection. Several factors can affect the probability of wound infection in this type of patient. Medical staff can intervene on the factors that have controllable significance, which is of great significance for improving the prognosis of patients.

关 键 词：四肢 深度烧伤 创面感染 皮肤 微生物 脓液 分泌物 负压引流 

分 类 号：R644[医药卫生—外科学]