动物致伤伤口感染处置经验研究  

Study of experience in the treatment of wound infection caused by animals

作　　者：彭志敏 PENG Zhi-min(Department of General Surgery,Tianjin Dongli Hospital,Tianjin 300300,China)

机构地区：[1]天津市东丽医院普外科,天津300300

出　　处：《中国城乡企业卫生》2024年第11期15-17,共3页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：目的 分析动物咬伤门诊动物致伤后感染处置的经验和教训,为今后的临床工作提供帮助。方法 总结2019年9月—2023年9月天津市东丽医院201例动物致伤后伤口感染患者的临床资料、门诊处置经过及预后,分析动物致伤伤口感染患者特点。结果 所有患者感染伤口均为Ⅲ级暴露伤口,致伤动物绝大多数为犬和猫,呈现明显的春、夏季高发特点。感染伤口多数位于四肢,手部更多见。伤口经过外科处置及抗生素治疗全部愈合。动物致伤伤口是否一期缝合问题目前仍具有争议,一期缝合伤口的前提基础是临床无感染、伤口彻底的冲洗、清创。一期缝合后伤口一旦感染化脓后愈合时间将会明显延长。该组患者中11例为一期缝合后伤口继发感染,平均就诊时间明显高于未缝合的感染伤口就诊时间。结论 充分评估伤口情况,根据伤口是否感染采取相应的外科处理措施,合理使用抗生素,在彻底冲洗、清创的基础上进行一期缝合,将有效提高动物致伤伤口的愈合效果,为动物致伤伤口感染处置提供指导。Objective To analyse the experiences and lessons of the treatment of post-traumatic wound infection caused by animals in outpatient department animal bite clinic,and to provide help for future clinical work.Methods The clinical data,outpatient treatment process and prognosis of 201 patients with post-traumatic wound infection caused by animals in Tianjin Dongli Hospital from September 2019 to September 2023 were summarized,the characteristics of patients with wound infection caused by animals were analyzed.Results The infected wounds of all patients were grade II open wounds.The majority of the injured animals were dogs and cats,showing obvious high incidence characteristics in spring and summer.Most of the infected wounds were located in the limbs,especially in the hands.The wound healed after surgical treatment and antibiotic treatment.At present,it was still controversial whether the wound caused by animals should be sutured at the first stage.The premise of the wound sutured in the first stage was that there was no infection,and the wound was thoroughly washed and debrided in clinic.The healing time of the wound after primary suture was significantly prolonged once the wound was infected and suppurated.In this group,1l cases were secondary infection after primary suturing,the average time of seeing a doctor was significantly longer than that of non-sutured infected wounds.Conclusion The wound condition was fully evaluated,the appropriate surgical treatment measures were taken based on whether the wound was infected,the antibiotics were used rationally,and the primary suture was performed on the basis of the irrigation and debridement,which would effectively improve animal wound healingeffect,in order to provide guidance for the wound infection caused by animals.

关 键 词：动物致伤 伤口感染 急诊处理 伤口冲洗 一期缝合 

分 类 号：R605.97[医药卫生—急诊医学]