骨关节创伤及内固定术后感染的抗菌药物应用分析

Application of antibiotics for infections after bone joint trauma and internal fixation

目的探讨骨关节创伤及内固定术后感染患者的抗菌药物应用情况。方法回顾性分析医院2010年2月至2011年1月收治入院的680例骨关节创伤及内固定患者病历资料,分析感染患者抗菌药物应用情况及病原菌药敏试验结果。结果感染患者共10例,感染率为1.47%;均在术后3d预防性应用抗菌药物,停用后5～8d出现感染,平均发生时间6.2d;10例患者术前应用抗菌药物包括头孢曲松、头孢呋辛、克林霉素;术后应用头孢呋辛、克林霉素、头孢曲松、头孢唑肟;病原菌包括金黄色葡萄球菌、表皮葡萄球菌、铜绿假单胞菌、不动杆菌属、肠杆菌科细菌;经过对患者严格消毒、换药,根据药敏结果使用抗菌药物,感染患者均痊愈。结论骨关节创伤及内固定手术患者应根据病原菌特点、易感因素针对性选用抗菌药物,对术后感染控制起到重要作用。

OBJECTIVE To explore the application of antibiotics for the infections after the bone joint trauma and internal fixation.METHODS A total of 680 patients with bone joint trauma and internal fixation who enrolled the hospital from Feb 2010 to Jan 2011 were selected as the study objects,the clinical data were retrospectively analyzed,the use of antibiotics for the patients with infections as well as the result of drug susceptibility testing was analyzed.RESULTS The infections occurred in 10 cases with the infection rate of 1.47%;all the 10 patients were with antibiotic prophylaxis 3d after the surgery,and the infections occurred in 5-8 days after the drug withdrawal with a median time of 6.2d;the preoperative antibiotics used by the 10 patients included ceftriaxone,cefuroxime,and lincomycin;the postoperative antibiotics included cefuroxime,lincomycin,ceftriaxone,and ceftizoxime;the pathogenic bacteria included Staphylococcus aureus,S.epidermidis,Pseudomonas aeruginosa,Acinetobacter baumannii,and Enterobacteriaceae;through the strict disinfection,dressing,and use of antibiotics according to the drug susceptibility testing,all the patients were healed.CONCLUSION The patients with bone joint trauma and internal fixation should use antibiotics according to the characteristics of the pathogens and susceptible factors,which plays an significant role in control of postoperative infections.