摘要
目的本文旨在探讨慢性骨髓炎患者清创术中不同细菌送检套数与确定致病菌之间的关系。方法本研究收集2007年1月至2014年1月255例慢性骨髓炎患者的临床资料,其中男性202例,女性53例;年龄15～84岁,平均年龄(45.2±16.5)岁。共送检细菌培养295次,其中送检套数分别为:63次(1套)、76次(2套)、51次(3套)、41次(4套)、64次(5套)。计算出总体细菌谱、各套数检出的细菌数及检出致病菌能力,并对其各套数之间进行比较,得出结论。结果在295次送检细菌培养中,共检出细菌42种,前5位分别是金黄葡萄球菌(35.51%)、表皮葡萄球菌(14.29%)、铜绿假单胞菌(9.80%)、阴沟肠杆菌(5.31%)、大肠埃希菌(4.49%);各套细菌检出率依次为66.7%(1套)、69.7%(2套)、74.5%(3套)、78.0%(4套)及90.6%(5套及以上);确定致病菌能力依次为42.1%(2套)、51.9%(3套)、68.3%(4套)、82.8%(5套及以上),各套数之间比较结果为2套与4套、2套与5套、3套与5套之间P<0.05,差异有统计学意义。结论在确定致病菌方面,术中送检5套及以上细菌检出致病菌能力最强,1套送检细菌检出致病菌能力最差。因此推荐在术中至少送检5套及以上细菌标本来确定致病菌。
Objective To examine the correlations between the bacteria-culture sample during the debridement in the operation and its ability to confirm the causative pathogens of chronic osteomyelitis.Methods 255 patients with chronic osteomyelitis in our hospital from January 2007 to January 2014,were selected in the current study.There were 202 male and 53 female,with the average age of(45.2±16.5)years(15~84 years).Bacteria were sent to culture for 295 times in total,in which there were one sample for 63 times,two samples for 76 times,three samples for 51 times,four samples for 41 times,and five samples for 64 times.After finishing the bacterium culture,bacterial spectrum,population and its ability to confirm the pathogens were calculated and different samples were compared.Results 42 kinds of bacteria were examined in the bacteria culture,the top five bacteria were Staphylococcus Aureus(35.51%),the Staphylococcus Epidermidis(14.29%),Pseudomonas Aeruginosa(9.80%),Enterobacter Cloacae(5.31%),and Escherichia Coli(4.49%).Detection rate among different samples were:66.7%(one sample),69.7%(Two samples),74.5%(Three samples),78.0%(Four samples),and 90.6%(Five samples or above).Percentage of pathogens detected in different samples were 42.1%(Two samples),51.9%(Three samples),68.3%(Four samples),and 82.8%(Five samples or above).The result of the comparison between two samples and four samples,two samples and five samples,three samples and five samples,were statistically significant(P<0.05).Conclusion Five samples sent to bacteria culture have the strongest detection ability of the causative pathogens,while one sample has the poorest detection ability.Therefore,at least five samples sent to bacteria culture to confirm the causative pathogen is recommended during the operation.
作者
马显志
王振栋
王满宜
张伯松
Ma Xianzhi;Wang Zhendong;Wang Manyi(Department of Orthopedics and Traumatology,People’s Hospital of Qinghai,Xining810000,China;Pediatric Surgery,Chinese PLA General Hopital,Beijing100853;Department of Orthopedics and Traumatology,Beijing Jishuitan Hopital,Beijing100035)
出处
《实用骨科杂志》
2018年第12期1085-1088,共4页
Journal of Practical Orthopaedics
关键词
慢性骨髓炎
细菌培养
套数
chronic osteomyelitis
bacteria-culture
samples
