摘要
目的:探讨影响地震创伤患者感染的流行病学特点及可能危险因素。方法:选择2013-04-20-2013-04-27我院收治的来自芦山地震灾区的260例创伤患者为研究对象。采集患者性别、年龄、创伤情况及感染发生情况等资料,分析患者一般情况与感染发生的关系。结果:260例患者中出现感染患者90例130例次,其中医院感染发生率为12.3%(32/260)。在90例并发感染的患者中,呼吸道感染53例次,伤口感染40例次,泌尿系感染11例次,胃肠道感染9例次,血液感染6例次,导管相关性感染6例次,五官和口腔感染5例次。共采集感染相关标本203份送微生物学检测,分离出的菌株包括鲍曼不动杆菌27例(28.4%)、大肠埃希菌23例(24.2%)、肺炎克雷伯杆菌15例(15.8%)、金黄色葡萄球菌14例(14.7%)、阴沟肠杆菌10例(10.5%)和其他6例(6.3%)。单因素基线资料比较中发现,感染组和非感染组患者的性别、受伤时间、多发伤、RTS评分、CRAMS评分、PHI评分比较差异无统计学意义。多元回归分析发现患者年龄、住院时间、入住ICU是地震创伤患者发生感染的主要危险因素(P<0.05)。结论:年龄、住院时间、入住ICU是地震伤员开放性创伤患者发生细菌感染的危险因素,提示在快速抢救伤员的同时,重视感染的危险因素,完善院感预防机制,采用有效措施控制创伤感染,对减少医院感染、改善患者预后有重要意义。
Objective：To study the characteristics and risk factors of infections in patients with earthquake injury.Method：From April 20,2013 to April 27,2013,260 cases of trauma patients after Lushan earthquake in Huaxi hospital of Sichuan University were studied.The data of gender,age,trauma and infection were collected and analyzed.Result：In 260 cases of patients,90 cases have infections,of which the incidence of nosocomial infection was12.3%（32/260）.Respiratory tract infection were found in 53 cases,wound infection in 40 cases,urinary tract infection in 11 cases,gastrointestinal infection in 9cases,blood infection in the second case,catheter related infections in 6cases,facial features and oral infection in 5cases.A total of 203 specimens were collected to send infection related microbiological detection,the isolated strains are Bauman Acinetobacter in 27cases（28.4%）,23 cases of Escherichia coli（24.2%）,15 cases of Klebsiella pneumoniae（15.8%）,Staphylococcus aureus in 14 cases（14.7%）,10 cases of Enterobacter cloacae（10.5%）,the other 6cases（6.3%）.There was no significant difference in gender,injury time,multiple injuries,RTS score,CRAMS score,PHI score between the infection group and the non-infected group.Multiple regression analysis showed that age,duration of hospitalization,treated in ICU were the main risk factors of infection in patients with earthquake trauma（P〈0.05）.Conclusion：Age,hospitalization time,treated in ICU were risk factors for infection details of earthquake trauma patients,suggesting that in the rapid rescue of the wounded at the same time,pay attention to the risk factors of infection,improve the hospital infection prevention mechanism,adopt effective measures to control the injury of dye,and reduce hospital infection,has important significance to improve the prognosis of patients.
作者
梁镰静
李东泽
胡海
许树云
LIANG Lianjing LI Dongze HU Hai XU Shuyun(Department of Emergency Medicine, West China Hospital of Sichuan University, Chengdu 610041, China)
出处
《临床急诊杂志》
CAS
2017年第7期504-507,共4页
Journal of Clinical Emergency
基金
卫生部公益性行业科研专项(No:201302003)
关键词
地震
创伤
细菌感染
危险因素
earthquake
trauma
bacterial infection
risk factor
