本文關(guān)鍵詞： 骨折 內(nèi)固定術(shù) 手術(shù)部位感染 術(shù)后感染 危險因素　出處：《中國感染控制雜志》2017年04期 　論文類型：期刊論文

【摘要】：目的了解四肢骨折患者內(nèi)固定術(shù)后手術(shù)部位感染(SSI)的發(fā)病率和危險因素。方法收集某院2013年1月—2016年1月收治的四肢骨折接受內(nèi)固定手術(shù)治療的患者資料,將術(shù)后發(fā)生SSI的39例患者納入感染組,按1∶2的比例隨機抽取同期術(shù)后未發(fā)生SSI的78例患者作為對照組,分析SSI的危險因素。結(jié)果 4 125例骨折內(nèi)固定患者術(shù)后SSI發(fā)生率為0.95%(39例),感染組細菌培養(yǎng)陽性率為87.2%(34/39),共分離病原菌38株,其中革蘭陽性菌22株(57.9%),革蘭陰性菌15株(39.5%),真菌1株(2.6%),金黃色葡萄球菌是主要致病菌(47.4%),多重耐藥菌20株。單因素分析結(jié)果顯示,合并基礎(chǔ)疾病、受傷至手術(shù)時間≥8 h、開放性骨折、多處骨折、手術(shù)時間≥180 min、術(shù)中失血量≥400 mL、術(shù)中輸入異體血、術(shù)后引流管留置時間≥5 d、平均住院時間≥14 d,感染組與對照組比較,差異有統(tǒng)計學(xué)意義(均P0.05)。多因素logistic回歸分析結(jié)果顯示,受傷至手術(shù)時間≥8 h、開放性骨折、手術(shù)時間≥180 min、術(shù)后引流管留置時間≥5 d、住院時間≥14 d是骨折內(nèi)固定術(shù)后SSI的危險因素(均P0.05)。結(jié)論四肢骨折內(nèi)固定術(shù)后患者發(fā)生SSI的危險因素較多,減少危險因素,對降低SSI發(fā)生率,提高治愈率有積極作用。
[Abstract]:Objective to investigate the infection of surgical site in patients with extremity fracture after internal fixation. Methods data of patients with limb fractures treated with internal fixation from January 2013 to January 2016 were collected. Thirty-nine patients with postoperative SSI were included in the infection group, and 78 patients without SSI were randomly selected as the control group according to the ratio of 1: 2. The risk factors of SSI were analyzed. Results the incidence of SSI in 4 125 patients with internal fixation of fracture was 0. 95% and 39 cases respectively). The positive rate of bacterial culture in the infected group was 87.2 / 39. 38 strains of pathogenic bacteria were isolated, of which 22 strains were Gram-positive bacteria and 15 strains were Gram-negative bacteria. Staphylococcus aureus was the main pathogen, and there were 20 strains of multidrug resistant bacteria. The results of univariate analysis showed that combined with basic diseases, the time from injury to surgery was more than 8 hours. Open fractures, multiple fractures, operative time 鈮，

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