腹部开放性创伤患者手术后医院感染病原学特征及危险因素探讨

Investigation on the etiological characteristics and risk factors of postoperatively nosocomial infections of patients with abdominally open trauma

目的:探讨腹部开放性创伤患者手术后医院感染病原学特征及危险因素。方法:选取医院收治的200例腹部开放性创伤患者,按照随机数表法将其分为对照组和观察组,每组100例。对照组给予常规治疗,观察组给予综合治疗,比较两组患者的术后感染情况,并对相关的感染危险因素进行分析。结果:观察组术后感染率为6.0%,显著低于对照组的34.0%;两组相比差异有统计学意义(x^2=24.500,P<0.05)。腹部开放性创伤术伤口感染菌株以表皮葡萄球菌较多,其次为金黄色葡萄球菌、肺炎克雷伯菌、粪肠球菌等。经多因素Logistic回归分析,Ⅲ类伤口类型、重度伤、住院时间>21 d和年龄>60岁均为腹部开放性创伤术后伤口感染的独立危险因素(OR=2.957,OR=1.051,OR=2.781,OR=3.463;P<0.05)。结论:腹部开放性创伤术后伤口感染危险因素较多,对腹部开放性创伤患者进行全面治疗,可以降低术后伤口感染率。

Objective:To investigate the etiological characteristics and risk factors of postoperatively nosocomial infections of patients with abdominally open trauma.Methods:200 patients with abdominally open trauma were selected and all of them were divided into observation group(100 cases)and control group(100 cases)by random number table method.The control group was implemented routine treatment and the observation group was implemented comprehensive treatment.And the postoperative infection of the two groups were compared,and the relevant risk factors of infection were further analyzed.Results:The postoperative infection rate of observation group(6%)was significantly lower than that of control group(34%)(x^2=24.500,P<0.05).In wound infection strains of abdominally open trauma,Staphylococcus epidermidis was more,and Staphylococcus aureus,Klebsiella pneumoniae,Enterococcus faecalis and so on were in the next place,respectively.The results of multiple factor Logistic regression analysis showed that type III wound,severe injury,the length of stay was more than 21 days and age was larger than 60 years were independent risk factors of operative wound infection of abdominally open trauma(OR=2.957,OR=1.051,OR=2.781,OR=3.463,P<0.05),respectively.Conclusion:There are many risk factors for wound infection of postoperatively abdominally open trauma,and the comprehensive treatment for patients with abdominally open trauma can reduce the postoperative infection rate of wound.