脊柱创伤患者术后医院感染危险因素及预防性护理对策

Risk factors and preventive nursing strategies for postoperative hospital infection in patients with spinal trauma

目的探讨脊柱创伤患者术后医院感染危险因素及预防性护理对策。方法选取我院2013年3月至2018年3月收治的脊柱创伤患者202例,并根据感染情况分为感染组15例和非感染组187例,对脊柱创伤患者术后医院感染危险因素进行分析。结果影响脊柱创伤患者术后医院感染单因素有年龄、BMI、并发症、手术方式、手术节段、输血情况、植骨情况、肢体制动时间、侵入性操作、抗菌药物使用疗程、导尿管留置、引流管使用、引流管使用天数(P<0.05)。影响脊柱创伤患者术后医院感染多因素为年龄≥60岁、BMI过高或过低、异体输血、异体植骨、抗菌药物使用疗程≥3个、引流管使用≥5d(P<0.05)。结论脊柱创伤患者术后医院感染危险因素较多,临床治疗和护理过程中在常规护理基础上加强针对性护理,重点关注年龄过高、BMI异常、异体输血、异体植骨及引流管使用时间过长患者,同时规范抗菌药物使用方案,合理提高患者自身抵抗力,可降低脊柱创伤患者术后医院感染概率。

Objective To explore the risk factors and and preventive nursing strategies for postoperative hospital infection in patients with spinal trauma.Methods To select 202 cases of patients with spinal trauma admitted to our hospital from March 2013 to March 2018.According to the infection status,15 cases were divided into infected group and 187 cases were divided into non-infected group.The risk factors of postoperative hospital infection in patients with spinal trauma were analyzed.Results The single factors affecting postoperative hospital infection in patients with spinal trauma were age,BMI,complications,surgical methods,surgical segment,blood transfusion,bone grafting,limb braking time,invasive operation,course of antibiotic use,and catheterization indwelling,the use of the drainage tube,and the use days of the drainage tube(P<0.05).The multi-factors affecting postoperative hospital infection in patients with spinal trauma were age≥60 years old,BMI was too high or too low,allogeneic blood transfusion,allogeneic bone grafting,course of antibiotic use≥3 times,drainage tube use≥5 d(P<0.05).Conclusion There were many risk factors for postoperative hospital infection in patients with spinal trauma.In the clinical treatment and nursing process,targeted nursing was strengthened on the basis of routine nursing,focusing on overage,BMI abnormality,allogeneic blood transfusion,allogeneic bone grafting and tube long-term use time of drainage in patients,while standardizing the use of antibiotics,rationally improve the patient's own resistance,could reduce the probability of postoperative hospital infection in patients with spinal trauma.