儿童骨科患者植入物感染的目标性监测及预防策略研究  

Study on targeted monitoring and prevention strategy of implant infection in pediatric orthopedic patients

作　　者：滕思思[1] 刘小艳[1] 徐倩 TENG Sisi;LIU Xiaoyan;XU Qian(Department of Anesthesia and Surgery,Hunan Province Children’s Hospital,Hunan Province,Changsha 410007,China)

机构地区：[1]湖南省儿童医院麻醉手术科,湖南长沙410007

出　　处：《中国医药导报》2024年第17期5-8,共4页China Medical Herald

基　　金：湖南省卫生健康委科研计划项目(202206023856)。

摘　　要：目的 探究儿童骨科患者植入物感染的目标性监测及预防策略研究。方法 回顾性分析2021年6月至2023年6月湖南省儿童医院收治的1 480例儿童骨科植入物患者的临床资料,根据术后植入物是否发生感染分为感染组和未感染组,分析儿童骨科患者植入物感染的影响因素。检索亚太感染控制协会网站、澳大利亚JBI循证卫生保健中心数据库、PubMed、中国知网等数据库中最新版本的循证指南、系统评价、专家共识。以循证卫生保健模式和德尔菲法为理论指导,构建预防儿童骨科植入物感染的循证实践方案。结果1 480例行骨科植入手术的患者中植入物感染12例,发生率为0.81%。两组年龄、手术时间、住院时间、伤口感染情况、抗菌药物使用情况、基础疾病比较,差异有统计学意义(P<0.05)。年龄、手术时间、住院时间、伤口感染情况、抗菌药物使用情况、基础疾病是儿童骨科患者植入物感染的危险因素(OR>1,P<0.05)。两轮专家函询问卷有效回收率和意见提出率皆为100%,专家权威系数均>0.9。经过两轮专家函询,最终形成预防儿童骨科患者植入物感染的循证实践方案共7个维度、31个条目。结论 开展目标性监测能及时了解儿童骨科患者植入物感染情况和高危因素,以此为基础构建的循证实践方案具有科学性和实用性,可为临床实践提供参考。Objective To explore the study on targeted monitoring and prevention strategy of implant infection in pediatric orthopedic patients.Methods The clinical data of 1480 pediatric orthopedic implant patients admitted to Hunan Province Children’s Hospital from June 2021 to June 2023 were retrospectively analyzed.According to whether the implant was infected after surgery,they were divided into infection group and non-infection group.The influencing factors of implant infection in pediatric orthopedic patients were analyzed.The latest versions of evidence-based guidelines,systematic reviews,and expert consensus in the websites of the Asia Pacific Association for Infection Control,the Australian JBI Evidence-Based Health Care Center database,PubMed,CNKI,and other databases were searched.Based on evidence-based health care model and Delphi method,an evidence-based practice scheme for preventing implant infection in pediatric orthopedic patients was constructed.Results Among the 1480 patients undergoing orthopedic implant surgery,12 cases were implant infection,with an incidence of 0.81%.There were statistically significant differences in age,operation time,hospital stay,wound infection situation,antibiotic use situation,and underlying diseases between two groups(P<0.05).Age,operation time,hospital stay,wound infection situation,antibiotic use situation,and underlying disease were the risk factors for implant infection in pediatric orthopaedic patients(OR>1,P<0.05).The effective recovery rate and opinion submission rate of the two rounds of expert correspondence questionnaires were 100%,and the expert authority coefficient was>0.9.After two rounds of expert correspondence,a total of 7 dimensions,31 items of evidence-based practice programs for the prevention of implant infection in pediatric orthopedic patients were finally formed.Conclusion The implementation of targeted monitoring can timely understand the implant infection situation and high risk factors of pediatric orthopedic patients,and the evidence-based practic

关 键 词：骨科 植入物感染 危险因素 预防策略 

分 类 号：R687[医药卫生—骨科学]