骨科清洁手术切口感染的相关因素研究

Study on related factors for cleaning surgical incision infections in orthopedics department

目的探讨骨科清洁手术切口感染原因以及预防控制感染措施的可操作性。方法目标性监测骨科清洁手术住院患者19 988例,依据卫生部颁布的《医院感染诊断标准》进行诊断;对其临床资料逐项填写统一表格,按照卫生部SSI监测中危险因素评分标准,计算感染危险因素指数,对统计数据进行χ2检验。结果 19 988例患者出现切口感染97例,感染率0.49%;92例患者送检标本中共分离出病原菌106株,革兰阳性菌70株,以金黄色葡萄球菌为主,占27.36%;革兰阴性菌33株,以假单胞菌属为主,占9.43%;真菌3株;手术切口感染与手术持续时间、手术前住院时间、手术部位、手术种类、术后感染时间、基础疾病、术中出血量及围手术期抗菌药物使用有明显关系,差异有统计学意义(P<0.05)。结论应加强骨外科手术切口医院感染的监测工作,采取针对性的措施,预防手术切口感染的发生。

OBJECTIVE To explore the causes of cleansing surgical incision infections in the orthopedics departments and maneuverability of the prevention and control measures for infections.METHODS The clinical data of 19 988 hospitalized patients were performed the targeted monitoring,the patients were diagnosed in accordance with the standards for diagnosis of nosocomial infections issued by the Ministry of Health in 2001.The risk factors indexes were calculated on the basis of scoring standards of risk factors monitored by the SSI,and the statistically analysis was performed by the chi-square test.RESULTS Of 19 988 patients investigated,the surgical incision infections occurred in 97 cases with the infection rate of 0.49%.Totally 106 strains of pathogens were isolated from the submitted specimens of 92 patients,including 70 strains of gram-positive bacteria,33 strains of gram-negative bacteria,and 3 strains of fungi.Staphylococcus aureus was the predominant species of gram-positive bacteria,accounting for 27.36%,Pseudomonas aeruginosa was dominant in the gram-negative bacteria,accounting for 9.43%.The surgical incision infections were significantly related to the surgery duration,preoperative hospitalization duration,surgical sites,surgery types,postoperative time,underlying diseases,intraoperative hemorrhage,and the use of antibiotics during the perioperative period,the differences were statistically significant（P 0.05）.CONCLUSION It should strengthen the monitoring of surgical incision infections in the orthopedic surgery department,and take relevant measures to reduce the incidence of surgical incision infections.