开放性骨折患者发生医院感染的临床特征及危险因素分析

Clinical Characteristics and Risk Factors of Nosocomial Infections in Patients with Open Fractures

目的:研究开放性骨折患者发生医院感染的临床特征及危险因素,为降低院内感染提供临床参考。方法:回顾性分析于2013年3月-2015年3月间院内收治的1860例开放性骨折患者临床资料,对存在院内感染患者的感染类型、病原菌类型及相关危险因素进行分析,应用SPSS19.0统计软件对数据进行研究。结果:1860例患者中共计65例出现医院感染情况,发生率为3.49%,感染类型主要为骨髓炎占35.38%,肺部感染伴血气胸占23.08%,颌面部创伤后发生颅内感染占18.46%;65株病原菌中包括38株革兰氏阴性菌,占58.46%,23株革兰氏阳性菌,占35.38%,4株真菌,占6.15%;病程、骨折部位、损伤程度及住院时间为开放性骨折医院感染的独立危险因素,差异具有统计学意义(P<0.05)。结论:通过分析开放性骨折患者医院感染的临床特征及危险因素,有利于医院防治工作的开展,为医院感染防治提供理论支持,具有重要指导意义。

Objective： To analyze the clinical characteristics of nosocomial infections in patients with open fractures and its risk factors,and to provide clinical reference for reducing nosocomial infections. Methods： The clinical data of 1860 patients with open fracture,who were admitted to Shanghai Armed Police Hospital from March 2013 to March 2015, were retrospectively analyzed. The infection type, pathogenic bacteria type and related risk factors of patients with nosocomial infections were analyzed by SPSS19.0 statistical software. Results： Among the 1860 patients,65 cases of hospital infection（3.49%）; the infection types were mainly osteomyelitis （35.38%）, pulmonary infection complicated with hemopneumothorax （23.08%）, maxillofacial trauma occurred intracranial infection （18.46%）. In 65 strains of pathogenic bacteria, there were 38 strains of gram negative bacteria （58.46%）, 23 strains of gram positive bacteria （35.38%）, 4 strains of fi.mgi （6.15%）. The course of disease, fracture site, damage degree and hospitalization time were independent risk factors of hospital infection of patients with open fracture, the differences were statistically significant （P〈0.05）. Conclusion： To analyze the clinical characteristics and risk factors of nosocomial infection in patients with open fracture is beneficial to the development of hospital prevention and control work and provides theoretical support for the prevention and treatment of hospital infection, which has an important guiding significance.