127例开放性骨折患者伤口感染的分析

The Bacterial Infection of Wound in 127 Patients With Open Fracture and It'S Therapy

目的探讨开放性骨折创口感染的细菌学特点和治疗方法。方法选择开放性骨折患者127例并发感染且细菌培养阳性的病例,对创口进行细菌学分析,进行清创处理后,常规短期应用抗生素,并根据细菌培养和药敏试验结果加以调整。结果在开放性骨折的伤口感染中,表皮葡萄球菌、铜绿假单胞菌最多见,几种主要致病菌对不同的抗生素具有不同的敏感性。127例病人随访122例,随访时间为术后6个月～3年,骨折正常愈合103例,延迟愈合10例,骨不连及骨坏死5例;4例病人由于所植皮坏死,出现骨外露。结论对开放性骨折伤口感染患者,及时进行清创处理和相应的治疗是控制感染和提高治愈率的有效措施。

Objective To study the bacteriological features and therapy methods of wound infection of open fracture. Methods Bacterial culture in 127 patients with open fracture complicated by bacterial infection were positive, and the bacteriology features were analyzed. Antibiotics were used routinely in short time after debridement, and adjusted antibiotics by the results of bacterial culture and drug sensitive test. Results Staphylococcus epidermidis and pseudomonas aeruginosa were most, some kinds of main pathogenic bacteria had different sensitive to different antibiotics. Among 127 patients, 122 patients were followed-up in half or 3 years, 103 cases healed, 10 cases were delayed union, 5 cases appeared nonunion and osteonecrosis, 4 patients' bone exposure caused by necrosis of s grafted kin. Conclusions Debridement and using antibiotics in time are effective measures for patients with open fracture complicated by bacterial infection.