骨外科手术切口医院感染相关因素分析

Nosocomial infection of surgical incision and its related factors in orthopedic surgery department

目的探讨骨外科手术切口医院感染特点及相关因素。方法回顾性分析3858例骨折住院患者的临床资料。结果 3858例患者共有71例发生手术切口感染,感染率为1.84%;71例患者送检标示中共分离出77株病原菌,有6例双重感染;革兰阴性菌50株,占64.94%,革兰阳性菌27株,占35.06%,以铜绿假单胞菌和金黄色葡萄球菌为主,分别占29.87%和23.38%;单因素2χ检验显示,手术切口感染与切口类型、手术时机、手术持续时间、手术前住院时间、骨折类型、围手术期抗菌药物使用以及是否有糖尿病有明显关系(P<0.05)。结论应加强骨外科手术切口医院感染的监测工作,有针对性的采取相关措施,预防手术切口感染的发生。

OBJECTIVE To investigate the clinical characteristics of nosocomial infection of surgical incision and its related factors in orthopedic surgery department.METHODS The clinical data of 3858 patients were retrospectively analyzed.RESULTS The surgical incisions in 71 cases were infected,showing an infectious rate of 1.84%.77 strains of pathogens were isolated from 71 patients,of which 6 cases were dual-infection.The Gram-positive（27 strains）and Gram-negative（50 strains） bacteria took a proportion of 35.06% and 64.94%,respectively.Pseudomonas aeruginosa and Staphylococcus aureus were the main bacteria,accouting for 29.87% and 23.38%,respectively.The correlation analysis showed that type of surgical incision,operative opportunity,operative time,hospital stay before operation,fracture type,application of antibiotics during perioperative period and diabetes were the risk factors of nosocomial infection（P0.05）.CONCLUSION It should strengthen the monitoring work for nosocomial infection of surgical incision in orthopedic surgery department,and take relevant measures to reduce the nosocomial infectious rate of surgical incision.