糖尿病慢性伤口感染患者的临床特点 及伤口愈合的危险因素分析

Analysis of clinical characteristics and risk factors of wound healing of diabetes mellitus patients with chronic wound infection

目的分析糖尿病慢性伤口感染患者的临床特点及伤口愈合的危险因素。方法回顾性分析2019年1月至2021年12月浙江省台州医院收治的160例糖尿病患者的病历资料及其糖尿病慢性伤口感染发生率,探讨影响糖尿病慢性伤口感染患者伤口愈合的危险因素。结果160例糖尿病患者中,90例发生慢性伤口感染,其中呼吸道感染占24.44%,泌尿道感染占18.89%,皮肤软组织感染占21.11%,消化道感染占23.33%,其他感染占12.22%。90例慢性伤口感染患者中共检出119株病原菌,其中耐甲氧西林金黄色葡萄球菌12株,肠球菌7株,铜绿假单胞菌26株,肺炎克雷伯菌14株,鲍曼不动杆菌20株,大肠埃希菌14株,白假丝酵母菌26株。患者年龄≥60岁、高中以下学历、住院时间≥4d、病程≥10年、合并脑血管疾病、有创治疗、血糖≥13.9mmol/L、血液透析、患有糖尿病并发症、应用抗菌药物为影响糖尿病慢性伤口感染患者伤口愈合的危险因素(P<0.05)。结论年龄、文化程度、住院时间、病程、合并脑血管疾病、有创治疗、血糖、血液透析、糖尿病并发症、应用抗菌药物为影响糖尿病慢性伤口感染患者伤口愈合的危险因素,且主要感染菌为革兰阴性菌,故有效防止感染的发生,对促进患者伤口愈合具有重要意义。

Objective To analyze the clinical characteristics and risk factors of wound healing of diabetes mellitus patients with chronic wound infection.Methods A retrospective analysis of 160 cases of diabetic patients admitted to Taizhou Hospital in Zhejiang Province from January 2019 to December 2021 was conducted to analyze the incidence of diabetic chronic wound infection and explore the risk factors affecting wound healing of patients with diabetic chronic wound infection.Results Among 160 diabetes mellitus patients,90 patients developed chronic wound infection,including 24.44%of respiratory tract infection,18.89%of urinary tract infection,21.11%of skin and soft tissue infection,23.33%of digestive tract infection,and 12.22%of other infections.A total of 119 strains of pathogenic bacteria were detected from 90 chronic wound patients,including 12 strains of methicillin-resistant staphylococcus aureus,7 strains of enterococcus,26 strains of pseudomonas aeruginosa,14 strains of klebsiella pneumoniae,20 strains of acinetobacter baumannii,14 strains of escherichia coli and 26 strains of candida albicans.Patients were aged≥60years,had less than a high school education,had a hospital stay of≥4d,had a disease duration of≥10years,comorbid with cerebrovascular disease,undergoing invasive treatment,had blood glucose≥13.9mmol/L,had hemodialysis,had diabetic complications,used antimicrobial agents as risk factors affecting wound healing in hospitalized diabetic patients with chronic wound infection(P<0.05).Conclusion Age,education level,length of hospital stay,course of disease,complicated cerebrovascular disease,invasive treatment,blood glucose,hemodialysis,diabetic complications and antibiotics were risk factors affecting wound healing in patients with chronic wound infection,and the main infectious bacteria were Gram negative bacteria.Therefore,it is important to effectively prevent the occurrence of infection and promote wound healing in patients.