汶川地震转运伤员创面感染的特点及治疗

Characteristics and treatment of wound infection of Wenchuan earthquake conveying patients

目的研究汶川地震转运外省创伤伤员创面感染的特点和治疗情况。方法对湖北省收治的84例汶川地震创伤伤员进行临床分析，统计伤员一般情况、创面感染、病原菌培养和药敏、救治效果等临床资料，并和同省其他转运伤员及未转运伤员的创面感染情况进行比较。结果地震伤员受伤部位以体表、四肢和骨盆、头颈部为主；感染部位为四肢和骨盆4例、头面部2例、胸部1例、体表1例。四地全部送检380份病原菌，检出率为75．79％，其中G-菌占61．35％。转运伤员的混合感染率显著高于未转运伤员（36．36％比50．00％；x2=21．40，P〈0．01）。全部培养中，前3位的细菌依次为大肠埃希菌56株（17．18％），阴沟肠杆菌44株（13．50％），凝固酶阴性葡萄球菌43株（13．19％），对37．06％的药物近乎完全耐药。结论地震伤员创面感染情况受到地域、伤情、急救措施的影响，转运伤员有着较高的混合感染率和病原菌耐药率。

Objective To study the characteristics and treatment of wound infection on Wenchuan earthquake conveying patients. Methods Totals of 84 cases of Wenchuan earthquake patients in Tongji hospital were compared with other conveying patients in Hubei province and uu - conveying patients in Sichuan province, such as general status, wound infection, bacteria cultures and drug susceptibility, treatment effect and so on. Results The major injury position was body surface, extremity and pelvis, head and neck. Major infection position were 4 cases of extremity and pelvis, 2 cases of head and face, 1 case of chest, and 1 case of body surface. And 380 cases of pathogen from four centers were tested： relevance rate was 75.79%, in which G- pathogen infection rate was 61.35%. Mixed infection rates of conveying patients was significantly higher than that of un-conveying patients（36.36% vs 50.00% ; X2 =21.40,P 〈0.01 ）. Among 380 pathogen,there were 56 numbers of eseherichia coli （17. 18% ）,44 numbers of enterobacter cloacae （13.50%）, 43 numbers of eoagulase negative staphylococci（ 13.19% ） ,and they were resisted for 37.06% drug. Conclusions Regions, injury state and emergency treatment are the influencing factors of infection situation of earthquake patients, and the conveying patients have higher mixed infection rates and drug resistance rates.