骨科手术部位感染病原菌及影响因素  

Pathogens and influencing factors of surgical site infection in department of orthopedics

作　　者：吴洋 来瑞平 张爽 明星 彭民金 谢多双 唐以军 WU Yang;LAI Rui-ping;ZHANG Shuang;MING Xing;PENG Min-Jin;XIE Duo-shuang;TANG Yi-jun(Hubei University of Medicine,Shiyan,Hubei 442000,China;不详)

机构地区：[1]湖北医药学院公共卫生与健康学院,湖北十堰442000 [2]十堰市太和医院(湖北医药学院附属医院),湖北十堰442000

出　　处：《中华医院感染学杂志》2024年第16期2472-2476,共5页Chinese Journal of Nosocomiology

基　　金：国家卫生健康委医院管理研究所医疗质量循证管理持续改进研究重点基金资助项目(YLZLXZ22K008);十堰市太和医院院级基金资助项目(2017JJXM021)。

摘　　要：目的分析骨科手术部位感染(SSI)的病原菌分布及影响因素。方法运用病例-对照研究方法,选取2021年6月-2023年6月在十堰市太和医院进行骨科手术治疗且发生术后手术部位感染的患者为病例组,共96例;在该医院进行骨科手术治疗且未发生术后手术部位感染的患者中按照发生月份1:4随机选择384例作为对照组,统计感染情况及病原菌分布,分析骨科患者手术部位感染的影响因素。结果研究期间9839例骨科手术患者共发生SSI96例,感染率为0.97%;骨科患者手术部位感染病原菌排名前三位分别是金黄色葡萄球菌(18.89%)、阴沟肠杆菌(11.11%)和大肠埃希菌(10.00%);多因素Logistic回归分析显示,手术时长>2h(OR=2.674,95%CI:1.502~4.762)、术中输血(OR=2.793,95%CI:1.1047.062)、引流天数(OR=1.157,95%CI:1.044~1.283)是骨科手术患者术后手术部位感染的危险因素,术前住院天数(OR=0.878,95%CI:0.781~0.988)是骨科手术患者术后手术部位感染的保护因素。结论骨科手术部位感染病原菌特征明确,手术时长、术前住院天数、是否输血、引流天数是其影响因素;应实施综合防治措施,降低骨科手术部位感染率。OBJECTIVE To analyze the related factors and pathogenic bacteria distribution of orthopaedic surgical site infection(SSI).METHODS A total of 96 patients with postoperative surgical site infection who underwent orthopaedic surgery in Taihe Hospital,from Jun 2021 to Jun 2023 were selected as the case group.Among the patients who underwent orthopaedic surgery and did not have postoperative surgical site infection in this hospital,384 cases were randomly selected as the control group according to the occurrence month 1:4.The infection situation and pathogenic bacteria distribution were analyzed,and the influencing factors and pathogenic bacteria of orthopaedic patients with surgical site infection were analyzed.RESULTS There were 96 cases with SSI and the infection rate was 0.97%.Staphylococcus aureus(18.89%),Enterobacter cloacae(11.11%)and Escherichia coli(10.00%)were the top three pathogens of surgical site infection in orthopaedic patients.Multivariate logistic regression analysis showed whether the duration of operation was longer than 2 hours(OR=2.674,95%CI:1.502-4.762),Whether there was bleeding during the operation(OR=2.793,95%CI:1.104-7.062),and the number of drainage days(OR=1.157,95%CI:1.044-1.283)was an independent risk factor for postoperative surgical site infection in orthopedic surgery patients,and the length of hospitalization before surgery(OR=0.878,95%CI:0.781-0.988)was a protective factor for postoperative surgical site infection in orthopedic surgery patients.CONCLUSION The pathogenic bacteria characteristics of orthopaedic surgical site infection are clear,the duration of operation,the number of days in hospital before surgery,whether blood transfusion,drainage days are the influencing factors.Comprehensive prevention and treatment measures should be taken to reduce the infection rate of orthopedic surgical site.

关 键 词：骨科手术 手术部位感染 术后感染 影响因素 病例-对照研究 病原菌 

分 类 号：R619.3[医药卫生—外科学]