本文選題：股骨頸修復(fù)　切入點：手術(shù)部位感染　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過對行股骨頸修復(fù)手術(shù)患者開展手術(shù)部位感染目標(biāo)性監(jiān)測,了解手術(shù)部位感染發(fā)生率和手術(shù)部位感染危險因素,逐步推進各項干預(yù)措施,提高干預(yù)措施的依從性,降低手術(shù)部位感染發(fā)生率。方法:對山西省兩所三級醫(yī)院2015年1月1日-2016年12月31日行股骨頸修復(fù)手術(shù)的493例患者進行目標(biāo)性監(jiān)測,由課題組成員統(tǒng)一填寫《手術(shù)部位感染監(jiān)測表》和《手術(shù)部位感染防控措施依從性監(jiān)測表》,調(diào)查內(nèi)容包括患者的基本信息、手術(shù)信息、手術(shù)部位感染情況、是否采用干預(yù)措施等情況。所有數(shù)據(jù)均使用SPSS17.0統(tǒng)計軟件進行處理,對患者的一般資料采用率、百分比等描述性指標(biāo),探討股骨頸修復(fù)患者發(fā)生手術(shù)部位感染的發(fā)生現(xiàn)狀及引發(fā)感染的危險因素。結(jié)果:1.2015-2016年共監(jiān)測股骨頸修復(fù)手術(shù)患者493例,男性221例,女性272例。年齡13歲-97歲,平均年齡為(66.27±15.23)歲,共7例發(fā)生手術(shù)部位感染,發(fā)生率為1.42%。其中表淺切口感染發(fā)生5例,占71.43%,深部切口感染發(fā)生2例,占28.57%。均未發(fā)生器官腔隙感染。2.將各手術(shù)醫(yī)師的手術(shù)部位感染發(fā)生率進行調(diào)正分析。感染專率調(diào)正前排名前三的依次為代號9(3.70%),5(2.70%),0(1.64%)的醫(yī)師,調(diào)正后排名前三的依次為代號5(1.78%),2(1.65%),3(1.58%)的醫(yī)師。3.7例發(fā)生手術(shù)部位感染患者,其中6例進行標(biāo)本送檢,共檢出9株病原菌,均為革蘭氏陰性菌,其中鮑曼不動桿菌(3株),居首位;無真菌和病毒感染的發(fā)生。病原菌均為條件致病菌。結(jié)論:術(shù)前住院天數(shù)過長、術(shù)后住院天數(shù)過長、切口污染程度嚴重、手術(shù)持續(xù)時間過長、手術(shù)危險指數(shù)高是手術(shù)部位感染的危險因素,積極推進干預(yù)措施,發(fā)現(xiàn)和解決干預(yù)措施推進過程中存在的問題,可有效降低手術(shù)部位感染的發(fā)生。
[Abstract]:Objective: to investigate the incidence of surgical site infection and the risk factors of site infection in patients undergoing femoral neck repair, and to promote the intervention step by step and improve the compliance of intervention measures. Methods: objective surveillance was performed on 493 patients undergoing femoral neck repair from January 1st 2015 to December 31st 2016 in two tertiary hospitals in Shanxi Province. The members of the research group filled out the "Surveillance form of infection at Operation site" and "Compliance Monitoring form of Prevention and Control measures for infection of Operation site". The contents of the investigation included the basic information of patients, the information of operation and the situation of infection of surgical site. All the data were processed by SPSS17.0 statistical software, and the rate and percentage of the general data of the patients were used as descriptive indicators. To investigate the present situation of surgical site infection in femoral neck repair patients and the risk factors of infection. Results A total of 493 femoral neck repair patients (221 males and 272 females) were monitored during 2015-2016. The average age was 66.27 鹵15.23 years (ranging from 13 to 97 years). The operative site infection occurred in 7 cases (1.42%), including superficial incision infection in 5 cases (71.43%), deep incision infection in 2 cases, deep incision infection in 2 cases, superficial incision infection in 5 cases (71.43 cases), deep incision infection in 2 cases. No organ lacunar infection was found in 28.57.The incidence of infection at the surgical site of each surgeon was adjusted and positive analysis was carried out. The first three who ranked the first three before adjusting the specific rate of infection were the doctors with the code number 93.70, 52.70 and 1.64, respectively. The first three of them were doctors who had infection in operation site, including 6 cases, 9 strains of pathogenic bacteria were detected, all of them were Gram-negative bacteria. Among them, 3 strains of Acinetobacter baumannii were in the first place, among them, 3 strains of Acinetobacter baumannii were in the first place. The pathogenic bacteria are conditional pathogens. Conclusion: the days of hospitalization before and after operation are too long, the degree of wound contamination is serious, the duration of operation is too long. High surgical risk index is the risk factor of surgical site infection. It can effectively reduce the incidence of surgical site infection by actively promoting intervention measures and finding and solving the problems existing in the process of intervention.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.3

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