降低四肢骨折患者术后医院感染的临床研究

Clinical study of postoperative nosocomial infections in limb fractures patients

目的探讨微创经皮钢板内固定治疗四肢骨折的临床效果,以期提高临床诊治水平,降低医院感染发生率。方法选取2010年2月-2014年1月100例四肢骨折患者为研究对象,分成两组,对照组48例,予切开复位内固定治疗,观察组52例,予微创经皮钢板内固定治疗,观察治疗后临床效果和医院感染发生率。结果两组在手术时间、骨折临床愈合时间比较差异无统计学意义;而在术中出血量、住院时间、下地行走时间、术后引流量比较差异有统计学意义(P<0.05);对照组患者出现术后医院感染3例,感染率为6.25%,观察组未发生术后医院感染病例;对照组内固定松动、创口坏死或难愈合发生率分别为4.17%、6.25%,总发生率为27.08%;观察组固定松动、创口坏死或难愈合发生率均为0,总发生率为3.84%,两组比较差异也有统计学意义(P<0.05)。结论微创经皮钢板内固定治疗四肢骨折能降低医院感染发生率,缩短疗程。

OBJECTIVE To explore the clinical effect of minimally invasive percutaneous plate osteosynthesis on treatment of limb factures so as to improve the clinical diagnosis and treatment and reduce the incidence of nosoco‐mial infections .METHODS A total of 100 limb fractures patients who were treated in the hospital from Feb 2010 to Jan 2014 were recruited as the study objects and divided into two groups ,the control group with 48 cases was trea‐ted with open reduction and internal fixation ,while the observation group with 52 cases was given the minimally invasive percutaneous plate osteosynthesis ;the clinical therapeutic effects and the incidence of nosocomial infec‐tions were observed .RESULTS There was no significant difference in the operation duration or the clinical healing time of factures between the two groups;however ,there was significant difference in the intraoperative blood loss volume ,length of hospital stay ,time of walk on the ground ,or postoperative drainage volume （P〈0 .05） .The postoperative nosocomial infections occurred in 3 cases in the control group ,with the infection rate of 6 .25% , while the postoperative nosocomial infections did not occur in the observation group .The incidence of looseness of internal fixation was 4 .17% in the control group ,0 in the observation group;the incidence of wound necrosis or difficult healing was 6 .25% in the control group ,0 in the observation group;the total incidence rate was 27 .08%in the control group ,3 .84% in the observation group ,and there was significant difference between the two groups （P〈0 .05） .CONCLUSION The minimally invasive percutaneous plate osteosynthesis may reduce the incidence of nosocomial infections in the limb factures patients and shorten the treatment course .