莱芜地区骨科手术室植入物感染的危险因素分析及预防对策

Risk factors for implant infections in orthopaedic operating room in Laiwu area and prevention countermeasures

目的探讨莱芜地区骨科手术室植入物感染的危险因素,采取对应措施,降低感染率。方法选取2010年11月-2012年11月莱芜地区1769例在手术室行植入物的患者资料进行回顾性分析,对其在手术室内感染的相关因素进行分析。结果共有15例出现植入物感染,感染率为0.85%;手术时间>4h、抗菌药物使用不规范、急诊手术间、有外伤和基础疾病、急诊手术、住院时间>15d、侵入性操作是危险因素(P<0.05);感染以切口感染为主占53.3%,感染病原菌以金黄色葡萄球菌为主,感染的最直接原因是手卫生不达标;其中手术时间、手术类型、手卫生不达标是手术室植入物感染的高危险因素。结论手术室骨科植入物要进一步提高环境洁净度,强化无菌操作,重视手术时的配合,加强植入物的管理,以提高术后的临床效果,降低感染的发生率。

OBJECTIVE To study the risk factors for implant infections in the orthopaedic operating room and take corresponding countermeasures so as to reduce the infection rate.METHODS The clinical data of 1769cases of patients who underwent the implant surgery in the operating rooms of Laiwu area from Nov 2010to Nov 2012 were retrospectively analyzed,then the related factors for the infections in the operating rooms were analyzed.RESULTS In this study,the implant infections occurred in 15cases of patients with the infection rate of 0.85%.The long hospitalization duration（more than 4hours）,unreasonable use of antibiotics,emergency surgery,trauma,underlying disease,emergency surgery,and long length of hospital stay（more than 15days）were the risk factors（P0.05）.The incision infections ranked the first place（53.3%）.The Staphylococcus aureus was the predominant species of pathogen causing the infections,which was directly caused by the non-standard hand hygiene.The operation duration,types of surgery,and non-standard hand hygiene were the high-risk factors for the implant infections.CONCLUSIONIt is necessary to the further improve the environmental cleanliness of the implants in the orthopaedic operating rooms,focus on the aseptic operation and the cooperation during the surgery,and intensify the management of implants so as to improve the clinical therapeutic effect and reduce the incidence of infections.