老年烧伤患者继发感染的特征及炎症因子的变化

The characteristics and inflammatory factors changes of secondary infection in senile burn patients

目的 研究老年烧伤患者继发感染的特征及炎症因子的变化.方法 选择2010年1月～2012年12月浙江省台州医院烧伤科收治的60例老年烧伤患者为研究对象,将其分为发生继发性感染的观察组（21例）和未发生继发性感染的对照组（39例）.分析两组患者感染发生途径、病原菌种类以及炎症因子水平.结果 感染途径中创面感染占17.0％,肠源性感染占27.7％,肺部感染占34.0％;病原菌种类中金黄色葡萄球菌占34.5％,铜绿假单胞菌占24.1％,表皮葡萄球菌占10.3％;观察组患者的白细胞介素1、6、8（IL-1、6、8）以及肿瘤坏死因子α（TNF-α）水平[（172.8±32.4）pg/mL、（593.1±79.3） pg/mL、（41.9±7.3）ng/mL、（3.2±0.8）ng/mL]均高于对照组[（61.3±11.2）pg/mL、（214.6±44.2）pg/mL、（13.8±4.2）ng/mL、（1.3±0.2）ng/mL],差异均有统计学意义（均P＜0.05）.结论 创面、肠源性以及肺部感染是最常见的感染途径,金黄色葡萄球菌、铜绿假单胞菌、表皮葡萄球菌是最常见的病原体,且白细胞介素和肿瘤坏死因子与感染的发生密切相关.

Objective To research the characteristics and inflammatory factors＇ changes of the secondary infection in senile bum patients.Methods 60 patients with senile burn from January 2010 to December 2012 in Burn Department of Taizhou Hospital of Zhejiang Province were selected as study objects,and they were divided into observation group with secondary infection （21 cases） and control group without secondary infection （39 cases）.The infection way,kinds of bacteria species and the levels of inflammatory factors of two groups were analyzed.Results On the aspect of infection way,wound infection was 17.0%,enterogenic infection was 27.7%,lung infection was 34.0%; on the aspect of kinds of bacteria species,staphylococcus aureus was 34.5%,pseudomonas aeruginosa was 24.1% and staphylococcus epidermidis was 10.3%; the level of interleukin 1,6,8 （IL-1,IL-6,IL-8） and tumor necrosis factor-α （TNF-α） of observation group [（172.8±32.4） pg/mL,（593.1±79.3） pg/mL,（41.9±7.3） ng/mL,（3.2±0.8） ng/mL respectively] were higher than those of the control group [（61.3±11.2） pg/mL,（214.6±44.2） pg/mL,（13.8±4.2） ng/mL and （1.3±0.2） ng/mL respectively],the differences were statistically significant （all P 〈 0.05）.Conclusion Wound,enterogenic and lung infection are the most ways of secondary infection,staphylococcus aureus,pseudomonas aeruginosa and staphylococcus epidermidis are the most pathogens for secondary infection,and interleukin and tumor necrosis factor are closely related to secondary infection.