CAJ | 학술논문

目的：查找骨科患者手术部位感染的临床影响因素，探讨预防骨科手术部位感染的措施。方法收集2012年8月1日~2013年7月31日华北石油管理局总医院骨一科所有实施手术的患者，采用干预组合、目标性监测的方法，对无植入物手术患者监测至术后30 d，有植入物患者监测至术后1年。将所有调查资料进行归纳整理，进行统计分析，作出诊断性结论。结果共监测骨科手术382例，手术部位感染7例次，感染率为1.83%；Ⅰ类切口、Ⅱ类切口与Ⅲ+Ⅳ类切口感染率比较(0.64%、4.00%、14.29%)，差异有高度统计学意义(χ2=21.8559，P<0.01)；急诊手术感染率与择期手术感染率比较(9.52%、0.88%)，差异有统计学意义(P<0.01)；开放切口与闭合伤口感染率比较(8.77%、2.62%)，差异有高度统计学意义(χ2=13.6875，P<0.01)。结论骨科手术部位感染与急诊手术、开放伤口和手术切口的清洁程度密切相关。
목적：사조골과환자수술부위감염적림상영향인소，탐토예방골과수술부위감염적조시。방법수집2012년8월1일~2013년7월31일화북석유관리국총의원골일과소유실시수술적환자，채용간예조합、목표성감측적방법，대무식입물수술환자감측지술후30 d，유식입물환자감측지술후1년。장소유조사자료진행귀납정리，진행통계분석，작출진단성결론。결과공감측골과수술382례，수술부위감염7례차，감염솔위1.83%；Ⅰ류절구、Ⅱ류절구여Ⅲ+Ⅳ류절구감염솔비교(0.64%、4.00%、14.29%)，차이유고도통계학의의(χ2=21.8559，P<0.01)；급진수술감염솔여택기수술감염솔비교(9.52%、0.88%)，차이유통계학의의(P<0.01)；개방절구여폐합상구감염솔비교(8.77%、2.62%)，차이유고도통계학의의(χ2=13.6875，P<0.01)。결론골과수술부위감염여급진수술、개방상구화수술절구적청길정도밀절상관。
Objective To find out the clinical influencing factors for orthopedic surgical site infection in patients, and discuss measures to prevent orthopedic surgical site infection. Methods All patients in Department of First Or-thopaedics of General Hospital of North China Petroleum Administration from August 1, 2012 to July 31, 2013 were observed using a combination of interventions and target surveillance, patients without implants were monitored to 30 d postoperatively, patients with implants were monitored to 1 year postoperatively. All the survey data were collated and analyzed to statistical analysis, diagnostic conclusions were made. Results SSI occurred in 7 cases and the incidence of SSI was 1.83% in monitoring 382 cases of orthopedics patients, the difference in the incidence of SSI among type Ⅰ, typeII, typeⅢ +typeⅣ incision (0.64%, 4.00%, 14.29%) was statistically significant (χ2=21.8559, P<0.01);differ-ence between emergency operations and elective surgery (9.52%, 0.88%) was statistically significant (P< 0.01); differ-ence between the open wounds and the closed wounds was statistically significant (8.77%, 2.62%) (χ2=13.6875, P<0.01). Conclusion The infection of orthopedic surgical site is closely associated with emergency operation, open wounds and the degree of incision cleanliness.