CAJ | 학술논문

目的:调查骨科无菌手术切口感染发生情况,探讨其预防措施.方法:采用回顾性调查研究方法,对2007年1月至2008年12月间14 274例骨科无菌手术患者的切口感染情况进行调查分析.结果:14 274例骨科无菌手术患者中发生切口感染133例;其中2007年5 981例患者中发生切口感染78例,感染率为1.304%;2008年8 293例患者中发生切口感染55例,感染率为0.663%;2008年无菌手术切口感染率低于2007年(χ2=15.463 5,P＜0.000 1);2007年、2008年骨科无菌手术切口感染主要病原体中G+球菌与G-杆菌的比例,差异无统计学意义(χ2=1.354 9,P=0.244 4).结论:重视高危感染病例,减少待手术日数,合理应用抗菌药物,加强术中无菌及无创操作,进行手术医师切口感染专率监测,是降低骨科无菌手术切口感染率的有效措施;围手术期用药时,应根据病原体检测结果和药敏试验结果,选用对G+球菌和G-杆菌均有效的抗菌药物.
목적:조사골과무균수술절구감염발생정황,탐토기예방조시.방법:채용회고성조사연구방법,대2007년1월지2008년12월간14 274례골과무균수술환자적절구감염정황진행조사분석.결과:14 274례골과무균수술환자중발생절구감염133례;기중2007년5 981례환자중발생절구감염78례,감염솔위1.304%;2008년8 293례환자중발생절구감염55례,감염솔위0.663%;2008년무균수술절구감염솔저우2007년(χ2=15.463 5,P＜0.000 1);2007년、2008년골과무균수술절구감염주요병원체중G+구균여G-간균적비례,차이무통계학의의(χ2=1.354 9,P=0.244 4).결론:중시고위감염병례,감소대수술일수,합리응용항균약물,가강술중무균급무창조작,진행수술의사절구감염전솔감측,시강저골과무균수술절구감염솔적유효조시;위수술기용약시,응근거병원체검측결과화약민시험결과,선용대G+구균화G-간균균유효적항균약물.
Objective:To investigate the cases of incision infection after orthopedic aseptic operation and discuss the prevention measures. Methods:14 274 patients from Jan 2007 to Dec 2008 were surveyed for retrospective analysis on incision infection after orthopedic aseptic operation. Results:Totally 133 incision infection cases were reported from 14 274 cases. 78 incision infection cases were reported from 5 981 cases in 2007 and the incision infection rate in this cohort was 1.304%, while 55 incision infection cases were reported from 8 293 cases in 2008 and the incision infection rate in this cohort was 0.663%. The rate of incision infection after orthopedic aseptic operation in 2008 was lower than that in 2007(χ2=15.463 5,P<0.000 1). On the other hand, there was no statistical difference between 2007 and 2008 on ratio of G+ cocci and G- bacillus which were major pathogens of incision infection after orthopedic aseptic operation(χ2=1.354 9, P=0.244 4).Conclusion:High-risk cases should be pay attention to, and the time before operation should be reduced, and the antibiotic should be used reasonably, and Aseptic and Non-invasive operation should be emphasized, and the ratio of incision infection should be monitored, and all these measures can reduce the ratio of incision infection after orthopedic aseptic operation. Perioperative medication should be based on results of pathogens detection and drug sensitivity test and those effective drugs against both G+ cocci and G- bacillus should be used.