不同敷料对骨折外固定患者针孔感染的预防研究

Study on different dressings in preventing pin tract infections for patients with bone fracture undergoing external fixator treatment

目的对比分析德莫林与聚维酮碘对骨折外固定架治疗患者针孔感染的预防控制效果,寻找预防针孔感染的有效措施。方法选取2011年1月-2015年6月医院进行外固定架治疗的骨折患者1 000例,采用随机数字表法分为观察组和对照组,每组各500例;观察组患者采用德莫林消毒针孔,对照组患者采用聚维酮碘消毒;记录两组患者每天更换敷料次数,针孔周围皮肤红肿及渗出等,并进行细菌培养;数据采用SPSS 20.0软件进行统计分析,计数采用χ2检验。结果患者术后第1~5天每天敷料更换率观察组显著低于对照组;术后第7天针孔处及周围皮肤出现红肿、渗出比例观察组显著低于对照组;观察组和对照组分别有4例和12例细菌培养结果阳性,感染率分别为0.8%和2.4%,以上差异均有统计学意义（P〈0.05）;观察组和对照组分别分离出病原菌7株和19株,均以金黄色葡萄球菌为主。结论对于四肢闭合性骨折患者外固定架治疗后采用德莫林处理针孔,可有效降低每天更换敷料的次数,降低红肿、渗出情况的发生,有效降低针孔感染率。

OBJECTIVE To comparatively investigate the preventing value of Dermlin vs.Iodophor for pin tract infections in patients with bone fracture undergoing external fixator treatment so as to find out an effective measure for pin tract infections.METHODS Totally 1000 cases of patients with bone fracture undergoing external fixator treatment in our hospital from Jan.2011 to Jun.2015 were divided into the observation group and the control group,500 cases in each group.Patients in the observation group were given Dermlin,while patients in the control group were given iodophor.The frequencies of postoperative dressing change,the conditions of the pin holes of external fixation and the redness,swelling and exudation of surrounding skin of the two groups patients were recorded and bacterial culture was performed.Data were statistically analyzed by software SPSS 20.0andχ2 test was used for numerical analysis.RESULTS At postoperative 1-5days,frequencies of postoperative dressing change in the observation group were significantly lower than that in the control group.There were 4（0.8%）and12cases（2.4%）with positive results in the observation group and the control group,respectively,with significant difference between two groups（P〈0.05）.Totally 7strains and 19 strains of pathogenic bacteria were isolated in the observation group and the control group,dominated by Staphylococcus aureus.CONCLUSIONFor bone fracture patients,using Dermlin after external fixator treatment could decrease frequencies of postoperative dressing change and the redness,swelling and exudation of surrounding skin and the infection rate.