摘要
目的探讨慢性感染性创面的治疗。方法回顾性分析2000~2010年该院收治225例慢性感染性创面患者的临床资料。结果 (1)慢性感染性创面以创伤性溃疡、压疮、术后溃疡、糖尿病性溃疡、血管性溃疡为主,占80.4%(181/225)。(2)创面细菌培养阳性率为87.1%(196/225),共培养46种,342株病原菌,革兰阳性菌40.6%(139/342),革兰阴性菌57.6%(197/342),真菌1.8%(6/342),以金黄色葡萄球菌(52株)、大肠埃希菌(43株)、铜绿假单胞属(44株)、肺炎克雷伯(27株)等为主,对青霉素、红霉素、氨苄西林、庆大霉素、复方新诺明等高度耐药,多重耐药率达37.1%(127/342)。从2007年后慢性创面及多重耐药菌呈迅速增加趋势。(3)201例行局部抗菌药物治疗,208例(49例行再手术)行手术封闭创面治疗,213例治愈,12例因经济等原因未愈出院。结论慢性创面感染受多种因素共同影响,注重清创,合理的选择,循环、交替使用抗菌药物以及创面床准备,早期手术封闭创面,能有效控制创面感染,促进创面愈合。
Objective To explore the treatment of chronic infective wounds. Methods A retrospective analysis of clinical data in 225 patients were admitted from 2000 to 2010. Results （1） They were mainly traumatic ulcers, pressure ulcers, postoperative ulcers,diabetes ulcers, vascular ulcers in the group, accounted for 80.4 % （181/225）. （2） Bacterial culture positive rate was 87. 1 （196/225） ,a total of 46 kinds with 342 pathogens were cultured,gram-positive bacteria 40. 6%（139/342）;gram-negative bacteria 57.6 % （ 197/342） ; Fungi 1.8 % （ 6/342）. The main pathogens were S. aureus （ 52 ）, E. coli （ 43 ）, P. aeruginosa （ 44 ）, Klebsiella. SPP （27）, which were highly resistant to penicillin, erythromycin, ampicillin,gentamicin, cotrimoxazole and the multidrug resistance rate was 37.1 % （127/342）. Chronic wounds and multidrug resistant bacteria showed rapidly increasing trend from 2007. （3） 201 patients with topical antibiotic treatment,208 patients（49 patiens underwent re-operation）underwent operations to close wounds^213 patiens were recovery, 12 patiens had to leave hospital because economic burden. Conclusion Chronic infective wounds were affect- ed by many factors, emphasizing on debriding, reasonablechoice, circulative,alternate use of antibiotics and wound bed preparation, appling surgery to close wounds in early stage could effectively control wound infection and promote wound healing.
出处
《重庆医学》
CAS
CSCD
北大核心
2013年第32期3883-3886,共4页
Chongqing medicine
关键词
感染
治疗
慢性感染性创面
创面床准备
infection
treatment
chronic infective wounds
wound bed preparation
