4022例骨折术后医院感染的调查与分析

Nosocomial infections in 4022 patients after fracture surgery

目的为进一步做好医院预防和减少骨折术后感染工作提供科学依据。方法从2009年1月1日-2011年8月30日对医院骨折手术4022例进行了医院感染监测。结果在所调查的4022例骨科患者中,发生医院感染者共38例,占0.9%;其中开放式骨折29例,占76.3%,截肢术后4例,占10.5%,闭合式骨折5例,占13.2%;38例医院感染中,术后伤口感染比例最高为25例,占65.8%;不同手术部位中,下肢感染病例较为多见共27例,占71.1%,尤以下肢、足踝多见;上肢感染病例为11例,占28.9%;骨折术后感染患者发病危险因素是手术部位、手术持续时间、住院时间、骨折类型等。结论骨折术后感染是多因素所致,工作中不仅要掌握一般临床手术基本技术,还要掌握无菌操作技术及其疾病治疗基础理论和护理经验;预防骨折术后感染是防治医院感染的重要环节,严格按照安全措施,重视各环节的质量控制,可降低骨折患者医院感染率。

OBJECTIVE To provide scientific bases for further prevention and reduction of nosocomial infections after fracture surgery.METHODS From Jan 1 2009 to Aug 30 2011,a total of 4022 patients who underwent fracture surgery were monitored for nosocomial infections.RESULTS In 4022 cases of orthopedic patients,there were 38 cases of nosocomial infections with the infection rate of 0.9%;there were 29（76.3%） patients undergoing the open fracture surgery,4（10.5%）patients undergoing amputation surgery,and 5（13.2%） patients undergoing closed fracture surgery;of 38 patients with nosocomial infections,there were 25（65.8%） patients with postoperative wound infections,which took the highest proportion;among the various surgical sites,there were 27（71.1%） patients with lower extremity infections which were more common in lower leg or the ankle;there were 11（28.9%） patients with upper extremity infections;the surgical site,operation duration,hospitalization duration,and fracture type were the risk factors for nosocomial infections after the fracture surgery.CONCLUSION The postoperative infections after fracture surgery are caused by multiple factors,it is necessary to grasp the primary surgery technique,aseptic operation technique as well as the basic theories and nursing experience of disease treatment;it is a important link to prevent nosocomial infections to prevent the infections after the fracture surgery,to strictly implement the safe measures and attach importance to the quality control of the links can contribute to the reduction of nosocomial infections in the fracture patients.