CAJ | 학술논문

目的：了解严重烧伤患者、急性感染期，创面感染菌群分布，为防治创面浸润性感染提供实验室依据。方法选择住院的、总面积（TBSA）＞31％、以深二度和三度为主的患者163例，性别年龄不居。在伤后13～15 d急性感染期，进行一次性创面分泌物普通培养，用VITEK2全自动细菌鉴定仪，进行细菌鉴定；药敏实验采用纸片扩散法程序进行操作，按美国临床实验室国家标准化委员会（NCCLS）标准进行结果判断。结果共得菌种24种、163株，阳性率为100％，其中假单孢菌属占首位（33．1％），次为球菌属（22．7％）。伤后10 d左右，预防性应用亚胺培南或头孢吡圬、万古霉素或呋喃妥因3 d；163例治疗期间均未发生伤面脓毒症，并顺利治愈。结论重度烧伤伤后13～15 d，应用亚胺培南或头孢吡圬、万古霉素或呋喃妥因，能预防创面脓毒症的发生和提高临床治愈率。
목적：료해엄중소상환자、급성감염기，창면감염균군분포，위방치창면침윤성감염제공실험실의거。방법선택주원적、총면적（TBSA）＞31％、이심이도화삼도위주적환자163례，성별년령불거。재상후13～15 d급성감염기，진행일차성창면분비물보통배양，용VITEK2전자동세균감정의，진행세균감정；약민실험채용지편확산법정서진행조작，안미국림상실험실국가표준화위원회（NCCLS）표준진행결과판단。결과공득균충24충、163주，양성솔위100％，기중가단포균속점수위（33．1％），차위구균속（22．7％）。상후10 d좌우，예방성응용아알배남혹두포필오、만고매소혹부남타인3 d；163례치료기간균미발생상면농독증，병순리치유。결론중도소상상후13～15 d，응용아알배남혹두포필오、만고매소혹부남타인，능예방창면농독증적발생화제고림상치유솔。
Objective To understand the bacteria distribution in wound infection during acute infection period in severely burned pa-tients and provide laboratory basis for preventing and treating the invasive infection.Methods One hundred and sixty-three patients with TB-SA more than 3 1% and deep Пdegree and Ш degree of injury were investigated.The wound secretion was cultured and identified using VITEK2 automatic bacteria device in 13 to 15 d of acute infection period.Drug sensitive experiment was implemented and analysed according to the NCCLS.Results Twenty-four kinds of bacteria(163 strains)were harvested,and the positive rate was 100%,including false single spore fungus(33.1%)and staphylococcus aureus(22.7%).The imipenem,cefepime engine-grease,vancomycin and nitrofurantoin were used for 3 d.The wound sepsis in 163 patients was not found,and all patients were successfully cured.Conclusion The application of imipenem, cefepime engine-grease vancomycin and nitrofurantoincan can prevent the occurrence of wound sepsis and improve the clinical cure rate 13 to 15 d after severe burn injury.