急诊新鲜小伤口细菌学分析及临床意义的研究  

Bacteriologic analysis and clinical significance research on fresh small wounds in emergency

作　　者：于甫[1] 尹少甫[2] 赵进昌[2] 

机构地区：[1]兰州医学院第一附属医院急诊科,兰州医学院微生物免疫学教研室,在职研究生730000 [2]兰州医学院微生物免疫学教研室

出　　处：《兰州医学院学报》2002年第4期42-46,共5页Journal of Lanzhou Medical College

摘　　要：目的　明确急诊新鲜小伤口细菌的种类和分布特点及与致伤器械、场所、部位等的关系 ,从而为经验性抗生素治疗提供科学依据。方法　用灭菌棉拭子随机取样 5 0 0例 ,筛选 35 0例 ,进行细菌学分析 ,设不同小伤口对照组与治疗组 ,比较使用与不使用抗生素的结果。结果　①定义了新鲜小伤口的诊断标准 ;②在 35 0份标本中 ,培养出细菌 1 5种 1 5 8株 ,培养阳性率 45 1 4% ;③分离的前 5位菌种分别为 :表皮葡萄球菌、金黄色葡萄球菌、克雷伯菌、鲍曼不动杆菌和枯草杆菌 ;④前 5位菌种在身体各部位的分布规律为 :表皮葡萄球菌和金黄色葡萄球菌以头、手分布较集中 ,其余 3种菌身体部位分布规律不明显 ;⑤分离菌种类与致伤器械和场所无明显关联性。⑥总结了小伤口抗生素使用规则。结论　处理各种类型的小伤口 ,严格无菌操作是预防感染发生的主要措施 。Objective To clarify the species of contaminated bacteria in fresh small wounds and their distribution characteristics as well as the relationship among contaminated bacteria and injury apparatus,sites,position and provide scientific evidence for experienced antibiotic treatment.Methods 500 cases were selected randomly by disinfected cotton swab.Out of them,350 cases were screened and bacteriologic analysis was carried out.Control and treated groups were set and the results were compared.Results 1 Diagnostic criteria of fresh small wounds was set in our study;2 15 species and 158 strains of bacteria were cultured in 350 cases and the positive culture rate was 45 14%;3 The first five bacteria in fresh small wounds contamination were differentiated:Staphylococcus epidermidis,Staphylococcus aureus,Klebsiella pneumoniae,Bordetella bacillus and Bacillus subtilis;4 The distribution regulation of the first five bacteria in various parts of human body was analyzed:Staphylococcus epidermidis and Staphylococcus aureus mainly distributed in heads and hands,the other three have no obvious distribution regulation;5 There was no correlation among the species of contaminated bacteria,injury apparatus and sites;6 Antibiotic administration regulation was summarized.Conclusions Strict aseptic manipulation and excellent surgery must be followed when dealing with this kind of wounds,and antibiotics may be administered if necessary.

关 键 词：急诊 小伤口 细菌学 临床意义 抗生素 

分 类 号：R641[医药卫生—外科学] R459.7[医药卫生—临床医学]