骨科患者术后医院感染的相关因素分析

Related factors for postoperative nosocomial infections in patients of department of orthopedics

目的探讨骨科患者术后发生医院感染的影响因素,以制定有针对性的干预措施。方法选取2012年2月-2013年6月82例行骨科手术且发生医院感染的骨折患者,对比其年龄、性别、骨折类型、基础疾病等因素在骨折患者医院感染中的相关性,并比较手术室净化度、手术持续时间、失血量及是否使用抗菌缝线对术后感染的影响。结果年龄、手术持续时间对医院感染的影响较小,而开放性骨折、合并有其他基础疾病、手术室净化度2级以下、失血量>800ml及普通丝线是造成患者发生医院感染的重要因素,与闭合性骨折、无基础疾病、手术室净化2级以上、<800ml失血量及抗菌缝线相比,差异有统计学意义(P<0.05)。结论提高手术室的净化级别、控制失血量、采用抗菌缝线是减少骨科医院感染率的重要措施,对于开放性骨折、合并有基础疾病的患者更有意义。

OBJECTIVE To explore the influencing factors for postoperative nosocomial infections in the patients of department of orthopedics so as to formulate targeted intervention measures .METHODS From Feb 2012 to Jun 2013 ,a total of 82 fracture patients who underwent surgery in department of orthopedics and were complicated with nosocomial infections were enrolled in the study ,then the correlation between the age ,genders ,types of fracture ,underlying diseases ,and the incidence of nosocomial infections was observed ;the effects of cleanliness degree of operating rooms ,operation duration ,volume of blood loss ,and use of antibacterial sutures on the inci-dence of postoperative infections were compared .RESULTS The age and operation duration had little effect on the incidence of nosocomial infections ;however ,the open fracture ,complication of other underling diseases ,operating room′s cleanliness degree below grade 2 ,blood loss volume more than 800 ml ,and common stitches were the pre-disposing factors for nosocomial infections in the patients ;as compared with the patients with closed fracture , without complication of underlying disease ,operating room′s cleanliness degree above grade 2 ,blood loss volume less than 800ml ,and antibacterial sutures ,the differences were significant （P〈0 .05） .CONCLUSION It is of great significance for the open fracture patients complicated with underlying disease to raise the cleanliness grade of op-erating room ,control the blood loss volume ,and use antibacterial sutures so as to reduce the incidence of nosoco-mial infections in the department of orthopedics .