四肢开放性骨折并发感染的危险因素分析及对策

Risk factors and countermeasures of infection complicated by open limb fractures

目的研究四肢开放性骨折并发感染的危险因素,为降低临床感染率提供科学依据。方法收集医院2003年9月-2010年9月收治的250例开放性骨折患者的资料,研究合并感染的发生率,并比较感染与未感染患者的年龄、性别、是否使用钢板、是否遗留死腔、清创时间、入院时间等的差异。结果 250例患者中发生感染57例,感染率为22.8%,感染组与非感染组的性别差异无统计学意义;感染组的平均年龄为(46.24±11.31)岁,大于非感染组的(37.43±10.11)岁;感染组钢板使用率为66.7%,明显高于非感染组的15.5%;感染组中遗留死腔比例为26.3%,明显高于非感染组的10.9%;而感染组的平均清创时间为(7.25±1.31)h,长于非感染组的(4.10±1.11)h。结论年龄大、术中使用钢板、遗留死腔、清创时间长等是四肢开放性骨折发生感染的危险因素;应注意采取相对应的措施防范感染的发生。

OBJECTIVE To study the risk factors of infections in the patients with open limb fractures, and provide scientific basis for reducing the incidence of nosocomial infections. METHODS The clinical data of 250 open limb fracture patients who enrolled hospital from Sep 2003 to Sep 2010 were collected to observe the incidence of the concurrent infections, the age, gender, use of steel plate, remain of dead cavity, dehridement duration, and admission time were compared between the patients with infections and the patients without infections. RESULTS Totally 57 of 250 patients suffered from infections with the infection rate of 22.8% ; there was statistical difference between the infection group and the non--infection group in the gender; the average age of the infection group was （46.24±11.31） years , which was higher than（37.43±10.11） years of the non-infection group; the utilization rate of steel plate was significantly higher in the infection group （66. 7%） than in the non-infection group （15.5%） ; the remain dead cavity occupied higher proportion in the infection group （26.3%） than that of the non- infection group （10.9 %） ; the average debridement duration was longer in the infection group （7.25±1.31） h than in the non-infection group （4.10±1. 11）h. CONCLUSION The age, use of steel plate, remain dead cavity, and long debridement duration are the risk factors leading to the nosocomial infections in the patients during the treatment of open limb fractures; it is necessary to take the corresponding measures to prevent the nosocomial infections.