摘要
目的探讨骨折内固定术后早期感染的病原学分析及保留内固定物治疗临床效果,以期提高临床诊治水平。方法选取2010年2月-2014年2月110例骨折内固定术后早期感染患者为研究对象,对所有患者进行病原学分析,且平均分为观察组与对照组,每组各55例;对照组患者给予单纯抗菌药物治疗,观察组患者给予综合方法治疗,观察两组患者治疗后临床效果,数据采用SPSS 16.0软件进行统计分析。结果行骨折内固定术2 189例患者中有110例发生感染,感染率为5.02%;共分离出病原菌134株,以鲍氏不动杆菌为主,共41株占30.6%;对照组创面Ⅰ期愈合、Ⅱ期清创后愈合、感染复发、菌群失调发生率分别为70.91%、18.18%、10.91%、0;观察组分别为89.09%、10.91%、0、0,两组比较差异有统计学意义(P<0.05),且两组在住院、病原菌消除、渗液消失、体温恢复正常等时间、视觉疼痛模拟评分、治疗费用比较差异有统计学意义(P<0.05)。结论骨折内固定术后早期感染病原菌较多,采用保留内固定物治疗预后较理想。
OBJECTIVE To explore the etiology of postoperative early infections in the fracture patients undergoing internal fixation and observe the clinical effect of retention of internal fixture so as to improve the clinical diagnosis and treatment .METHODS A total of 110 fracture patients who underwent the internal fixation from Feb 2010 to Feb 2014 and had the postoperative early infections were recruited as the study objects and were divided into the observation group and the control group ,with 55 cases in each .The etiological analysis was conducted for all the participants ;the control group was treated with single antibiotics therapy ,and the observation group was given the comprehensive therapy .The clinical curative effect was observed and compared between the two groups of pa‐tients ,and the statistical analysis of data was performed with the use of SPSS 16 .0 software .RESULTS Of 2 189 fracture patients undergoing internal fixation ,110 cases had the infections ,with the infection rate of 5 .02% .To‐tally 134 strains of pathogens have been isolated ,of which 30 .6% （41 strains） were Acinetobacter baumannii . The rate of stage Ⅰ wound healing was 70 .91% in the control group ,89 .09% in the observation group ;the rate of wound healing after stage Ⅱ debridement was 18 .18% in the control group ,10 .91% in the observation group ;the recurrence rate of infections was 10 .91% in the control group ,0 in the observation group ;the rate of dysbac‐teriosis was 0 in the control group ,0 in the observation group ,and there was significant difference between the two groups （P〈0 .05）;there was significant difference in the length of hospital stay ,eradication rate of patho‐gens ,disappearance of exudates ,time of recovery of body temperature ,visual pain analog scale ,or cost of treat‐ment between the two groups （P〈0 .05） .CONCLUSION There are a variety of species of pathogens causing the postoperative early infections in the fracture patients undergoing internal fixation ,and the retention of the internal fixture may achieve ideal prognosis .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第16期3680-3682,共3页
Chinese Journal of Nosocomiology
基金
上海市卫生局重点扶持基金资助项目(SW-2012B-041)
关键词
骨折内固定术
早期感染
病原学
保留内固定物
疗效
Fracture internal fixation
Early infection
Etiology
Retention of internal fixture
Curative effect
