股骨粗隆间骨折支架外固定术后针道感染的预防

Prevention of needle passage infection after femoral intertrochanteric fracture external fixation

目的探讨股骨粗隆间骨折支架外固定患者术后针道感染的预防效果，分析影响术后针道感染率的因素。方法选取2012年7月-2013年3月在医院进行治疗的150例股骨粗隆间骨折支架外固定手术患者，将其随机分为日护理组和周护理组，每组各75例，日护理组每天进行1次护理工作，周护理组每周进行1～2次护理工作，并观察两组患者的手术部位针道细菌培养及不同时间点感染的发生。结果患者出现感染的比例会随着护理时间的增长而逐渐降低，日护理患者出现感染的概率较周护理患者低，两种方法之间的比较，差异无统计学意义；日护理组患者在第6周的分泌物阳性率为18．67％，与周护理组的40．00％比较，差异有统计学意义（P〈0．05），其他时间之间的比较，差异无统计学意义。结论对股骨粗隆间骨折支架外固定患者进行术后护理时应该严格保证患者手术创口的清洁，在换药过程中严格进行无菌操作，并合理使用抗菌药物，及时进行针道感染的检查有助于降低患者出现针道感染的概率。

OBJECTIVE To explore the prevention of needle passage infection after femoral intertrochanteric fracture external fixation and analyze about the effect factors on the postoperative pin tract infection rate. METHODS A total of 150 cases of patients with hospital treatment of femoral intertrochanteric fracture between 2012 Jul. to 2013 Mar. were selected and randomly divided into daily nursing service group and weekly nursing service group, 75 cases in each group. There was one time nursing every day in daily nursing service group and one to two times of nursing service for weekly nursing service group. The needle passage pathogen culture and different infection times were under observation. RESULTS The proportion of infections in patients gradually reduced as the nursing time increased, the daily nursing service group patients has lower infection rate compared with weekly nursing service group, but the difference between the two methods had no statistical significance. The positive rate of secretion during the sixth week of daily nursing service group was 18.67%, statistically significant different with that in the weekly nursing service group 40%, （P〈0. 05）. The comparison in other time had no statistical significance. CONCLUSION The nursing service to intertrochanteric fracture external fixation in patients should strictly ensure the operation wound clean, and perform strict aseptic manipulation in the dressing process. Rational use of antibiotics, timely pin tract infection examination could help to reduce the probability of occurrence of needle passage infection patients.