胫腓骨开放型骨折术后医院感染的病原菌特点及危险因素分析

Pathogen characteristics of nosocomial infection and risk factors after tibia and fibula open fracture

目的分析胫腓骨开放型骨折患者术后发生医院感染的病原菌分布及危险因素。方法回顾性分析2013年10月-2017年10月本院骨科收治的胫腓骨开放型骨折患者465例的临床资料,采用单因素和多因素分析确定胫腓骨开放型骨折患者术后发生医院感染的病原菌分布及危险因素。结果 465例胫腓骨开放型骨折中有48例患者共培养出71株病原菌,革兰阳性菌40株,革兰阴性菌31株。Logistic回归分析显示,年龄≥60岁、手术时间≥4 h、受伤到手术时间≥6 h、未彻底清创和皮瓣未覆盖创面是胫腓骨骨折患者术后发生医院感染的独立危险因素(P<0.05)。结论对胫腓骨开放型骨折术后发生医院感染危险因素、病原菌特点进行研究,临床上可以采取正确预防和治疗措施,合理使用抗生素。

Objective To analyze the distribution and risk factors of nosocomial infection in patients with open tibia and fibula fractures. Methods The clinical data of 465 patients with open tibia and fibula fractures admitted in our hospital from October2013 to October 2017 were analyzed retrospectively. Single factor and multivariate analysis were used to determine the pathogen distribution of nosocomial infection after open tibia and fibula fractures and risk factors. Results Of the 465 patients with open tibia and fibula fractures,there were 71 pathogens,40 strains of Gram-positive bacteria,31 strains of Gram-negative bacteria.Univariate analysis and further regression analysis of Logistic showed that the age of ≥60,the operation time ≥4 h,injury to hospital treatment time ≥6 h and defect flap coverage,tibia and fibula limb fractures were independent risk factors in patients with hospital infection. Conclusion The risk factors and pathogen characteristics of nosocomial infection after open fractures of tibia and fibula are studied. The correct prevention and treatment measures can be taken and the antibiotics can be used rationally.