下肢骨折患者创口感染原因分析及预防

Cause analysis and prevention measures of lower limb fracture wound infection

目的探讨下肢骨折创口感染的相关因素,为临床预防感染提供客观依据。方法将2011年6月-2012年6月发生感染的50例下肢骨折患者作为感染组,并同期随机选取50例未出现感染的下肢骨折患者作为对照组,比较两组患者的相关资料,寻找医院感染原因,采用SPSS17.0软件对数据进行统计分析。结果感染组患者骨折后至医院就诊时间>6h33例、清创时间>6h36例、院前有治疗不当35例,其分布率分别为66.00%、72.00%、70.00%,对照组分别为22.00%、14.00%、22.00%;两组损伤程度结果显示,感染组骨折损伤程度显著高于对照组,损伤程度越高,创口感染发生率越高,差异有统计学意义(P<0.05);下肢骨折创口感染组患者手术时间一般较长,明显多于对照组,差异有统计学意义(P<0.05)。结论下肢骨折患者创口感染与骨折后至就诊、清创时间长、骨折损伤程度严重、手术时间长、术后护理不得当等多种因素有关,医务人员应及时采取有针对性的护理措施预防创口感染的发生。

OBJECTIVE To investigate the relevant factors of wound infections of lower extremity fractures and provide the objective basis for the clinical preventive measures of infections. METHODS A total of 50 cases of nosocomial infections in patients with lower extremity fractures from Jun. 2011 to Jun. 2012 were selected as the infection group and 50 cases were randomly selected from the same period in hospital infection without lower extremity fracture patients as the control group, and relevant causes of nosocomial infections and the statistical inmation of the two groups were compared to find analysis of the data were performed with SPSS 17.0 software RESULTS Hospitalization time due to fracture〉 6h were 33 cases of in observed group, accounting for 66.00% the debridement time〉 6h were 36 cases in observation group, accounting for 72.00% improper treatment of pre-hospital were 35 cases in observation group, accounting for 70%, while were 22.00%, 14.00%, 22.00% in control group. The results of degree of injury between the two groups showed that degree of injury in the infection group was significantly higher than that in the control group. The higher the degree was, the higher the incidence of wound infection, and the difference was significant （P^0.05）~ the surgical time was generally longer in the lower limb fracture patients with wound infection group, which was significantly longer than the control group（P 〈0.05）. CONCLUSIONS Lower limb fractures and fractures to hospital infection has connection with long time wound debridement treatment time, serious fracture injury, operation time, improper treatment of postoperative care and other factors, and the medical staff should take timely and targeted measures to prevent wound care hospital infections.