开放性骨折患者伤口不动杆菌感染的临床探讨

Acinetobacter Infection in Non-healing Wounds of Fracture Patients:A Clinical Analysis

目的 探讨骨折患者伤口不愈合不动杆菌感染的原因、规律 ,以利防范。方法 对我院 1999年 1月～ 2 0 0 2年 3月间 ,骨折后不愈合伤口分泌物标本 ,细菌学培养不动杆菌阳性的 3 3例住院患者的多种临床因素进行回顾性分析。结果 多种不同因素与骨折后伤口不愈合不动杆菌感染有关 ,诸如伤口开放、手术实施、联合长期应用广谱抗生素有关 ,而与年龄、慢性疾病的有否、糖皮质激素的应用与否无关。结论 骨折患者不愈合伤口预防不动杆菌感染的关键在于合理应用抗生素 ,严格无菌操作 。

OBJECTIVE To investigate the causes and regularities of Acinetobacter infection of the non healing wounds of fracture patients. METHODS To study retrospectively clinical factors in 33 hospitalized fracture patients with non healing wounds and bacteriology culturing of their wound secretion positive to Acinetobacter in our hospital from Jan. 1999 to Mar. 2002, in order to provide a comprehensive intensive care. RESULTS Many susceptible factors were revealed to be responsible for the Acinetobacter infection in the non healing wounds of fracture patients, for example, wounds exposing surgical operation, combined and long term using broad spectrum antibiotics. Many susceptible factors were irresponsible, for instance, age, chronic diseases, using adrenocortical hormones. CONCLUSIONS The steps of prevention were mainly the strict aseptic manipulation,short wounds exposing and surgical procedure. The key is reasonable using antibiotics.