开放性骨折感染影响因素分析及彝医治疗经验分享

Influencing Factors of Open Fracture Infection and Yi Medicine Experience

目的探究开放性骨折感染影响因素及相应预防措施,并提出彝族医药早期干预开放性骨折,以期降低感染发生率,改善患者预后。方法回顾性分析我科2021年4月1日2022年3月31日收住的开放性骨折病例资料,并采用单因素分析、多因素Logistic分析,总结开放性骨折感染独立危险因素,同时总结彝医药治疗开放性骨折的临床经验。结果123例开放性骨折患者感染25例,感染率20.33%。经单因素及Logistic回归分析结果显示:年龄(≥60岁)、伤后至首次手术时间(>6 h)、手术时长(≥2 h)、GustiloⅢ型是术后创口感染的危险因素;彝药对开放性骨折有良好的疗效。结论开放性骨折术后感染与年龄(≥60岁)、伤后至首次手术时间(>6h)、手术时长(≥2 h)、GustiloⅢ型密切相关;应早期采取有针对性的综合干预措施如:强化基础病治疗,优化术前准备流程,提高医护人员专业知识和技术水平,早期彝族医药干预,降低感染发生率,促使患者及早康复。

Objective To explore the influencing factors of open fracture infection and the countermeasures and propose the early intervention of open fracture by Yi medicine to reduce the incidence of infection and improve the prognosis of patients.Methods The medical records of patients with open fractures in our department from April 1,2021 to March 31,2022 were retrospectively analyzed,and univariate analysis and multivariate Logistic analysis were used to summarize the independent risk factors of open fracture infection and the clinical experience of Yi medicine in the treatment of open fractures was summed up.Results Among the 123 open fracture patients,25(20.33%)suffered from infection.Results of univariate and Logistic regression analysis showed that age(≥60 years old),time from the injury to the first operation(>6 h),operation duration(≥2 h),and type GustiloⅢwere risk factors for postoperative wound infection.Yi medicine was effective for open fractures.Conclusion Postoperative infection of open fracture is closely related to age(≥60 years),first operation time(>6 h),operation duration(≥2 h),and GustiloⅢ.Targeted interventions should be taken early,such as strengthening basic disease treatment,optimizing preoperative preparation process,improving professional knowledge and technical level of medical staff,and early intervention of Yi medicine,so as to reduce the incidence of infection and promote the recovery.