口腔颌面肿瘤外科手术后感染的临床分析

Clinical analysis of postoperative infection in oral and maxillofacial surgery

目的探讨口腔颌面肿瘤外科术后感染的临床特征和病原菌种类,分析感染因素,提出相关护理对策。方法选取2012年1月至2015年6月间在西安交通大学口腔医院诊断的口腔颌面肿瘤外科手术后患者762例,用回顾性调查分析方法统计所有患者的临床资料,分析感染部位、种类和相关因素。结果 762例患者手术后感染26例,感染率为3.4%,其中感染部位最多为手术创面(46.2%),其次为下呼吸道感染(23.1%)、上呼吸道感染(11.5%)。革兰氏阳性菌15株感染占57.7%,其中金黄色葡萄球菌(34.6%)为主要感染病原菌。革兰氏阴性菌11株占42.3%,其中铜绿假单胞菌(23.1%)为主要感染病原菌。患者年龄、住院时间和护理方法为手术后感染的主要相关因素。结论感染部位最多为手术创面,金黄色葡萄球菌为主,患者年龄、住院时间和护理方法与手术后感染相关。临床中,应对各种可能引起手术后感染的危险因素进行积极的预防控制与护理工作。

Objective To investigate the clinical characteristics of postoperative infection in oral and maxillofacial surgery and the types of pathogenic bacteria. It also analyzed the infection factors and provided the related nurszing strategies. Methods 762 patients who underwent oral and maxillofacial surgery in Stomatological Hospital of Xi＇an Jiaotong University from January 2012 to June 2015 were selected. Using retrospective study method to analyze the clinical data of all patients,the infection sites,types and related factors were analyzed. Results Of the 762 patients,26 patients were infected after the surgery,with the infection rate of 3. 4%. 46. 2% of the infection sites were associated with operation wound followed by lower respiratory tract infection rate of 23. 1% and upper respiratory tract infection rate of 11. 5%. For Gram positive bacteria（ 15 strains）,the infection rate was 57. 7% with Staphylococcus aureus（ 34. 6%）being the main pathogenic bacteria. For gram negative bacteria（ 11 strains） the infection rate was 42. 3%with Pseudomonas aeruginosa（ 23. 1%） being the main pathogenic bacteria. Age of patient,hospital length of stay and nursing methods were the main factors related to postoperative infection. Conclusion Surgical wounds were the primary surgical infection sites,especially for Staphylococcus aureus. Age of patient,hospital length of stay and nursing methods were related to postoperative infection. Risk factors which can cause postoperative infection should be actively prevented and controlled and nursing service should be carried out in clinics.