骨科患儿手术切口感染因素分析及预防措施

Analysis of influcing factors of surgery incision infection in children with orthopaedics and preventive measures

目的分析骨科小儿手术部位感染风险因素,制定具有针对性的、有效的小儿骨科手术切口感染控制办法和措施。方法回顾性分析河北省儿童医院诊治的1 956例骨科患儿,将可能的小儿骨科手术野感染因素进行分析。结果 1 956例骨科手术患儿发生术后切口感染45例,感染率2.30%。经分离培养和常规细胞学分析,最常见的易感病原菌依次为大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌、阴沟肠杆菌、表皮葡萄球菌。感染的独立危险因素为急诊手术(感染31例,占4.61%,logistic分析P=0.010)、手术切口类型(Ⅲ类)(感染25例,占6.11%,logistic分析P=0.046)、免疫功能差(感染21例,占8.75%,logistic分析P=0.033)、术前没有应用抗生素(感染30例,占3.08%,logistic分析P=0.017)。结论制定合理预防措施,并针对性实施,可以降低小儿骨科手术切口感染率。

Objective To investigate the the risk factors of orthopaedic pediatric surgical site,and develop targeted and effective methods and measures to control infections in children with orthopedic diseases. Methods A retrospective analysis of 1 956 cases of children with orthopedic diseases diagnosed and treated in Children＇s Hospital of Hebei Province was conducted to analyze the possible infection factors of orthopaedic surgery in children. Results In 1 956 cases of postoperative orthopedic surgery,45 postoperative incision infections occurred and the infection rate was 2. 30%. After isolation and culture and routine cytological analysis,the most common susceptible pathogens were escherichia coli,staphylococcus aureus,pseudomonas aeruginosa,enterobacter cloacae,and staphylococcus epidermidis. The independent risk factors for infection were emergency surgery（ 31 infections,4. 61%,logistic analysis P = 0. 010）, surgical incision type（ Ⅲ）（ 25 infections,6. 11%, logistic analysis P =0. 046）,poor immune function（ infection was 21 cases,accounting for 8. 75%,logistic analysis P = 0. 033）,no antibiotics being applied before surgery（ infection 30 cases,accounting for 3. 08%,logistic analysis P = 0. 017）. Conclusion The establishment of reasonable preventive measures and targeted implementation can reduce the incidence of incision in children with orthopaedic diseases.