摘要
目的探究四肢骨折术后切口感染的病原菌分布及危险因素。方法回顾性分析山东大学齐鲁医院(青岛)2021年1月-2022年12月收治的3987例四肢骨折患者临床资料,根据术后感染情况将有切口感染的158例纳入感染组,无切口感染的3829例纳入非感染组,统计感染组病原菌分布特点;四肢骨折患者术后切口感染发生的危险因素利用Logistic回归法进行分析。结果3987例四肢骨折患者术后发生切口感染158例,切口感染发生率为3.96%;共分离158株病原菌,革兰阴性菌64株(40.51%)、革兰阳性菌90株(56.96%)、真菌4株(2.53%);感染后白细胞介素-6(IL-6)、降钙素原(PCT)、C-反应蛋白(CRP)表达水平升高(P<0.05);多因素Logistic分析结果显示,合并糖尿病、有钢板使用、手术时间>3 h、开放性骨折、切口较长均是四肢骨折患者术后发生切口感染的危险因素(P<0.05)。结论革兰阳性菌是四肢骨折患者术后切口感染的主要病原菌,感染后炎症因子IL-6、PCT、CRP水平升高,术后切口感染的发生与糖尿病、钢板使用、手术时间、开放性骨折、切口及血清IL-6、PCT、CRP水平密切相关,临床可据此予以早期针对性防治而降低四肢骨折患者术后切口感染的发生风险。
OBJECTIVE To explore the distribution of pathogens and risk factors for postoperative incision infection in the limb fracture patients.METHODS The clinical data were retrospectively collected from 3987 patients with limb fracture who were treated in Shandong University Qilu Hospital(Qingdao)from Jan 2021 to Dec 2022.The patients were divided into the infection group with 158 cases and the non-infection group with 3829 cases according to the status of postoperative incision infection.The distribution of pathogens isolated from the infection group was statistically analyzed,and logistic regression analysis was performed for the risk factors for the postoperative incision infection in the patients with limb fracture.RESULTS Among the 3987 patients with limb fracture,158 had postoperative incision infection,with the incidence rate 3.96%.A total of 158 strains of pathogens were isolated,64(40.51%)of which were gram-negative bacteria,90(56.96%)were gram-positive bacteria,and 4(2.53%)were fungi.The expression levels of interleukin-6(IL-6),procalcitonin(PCT)and C-reactive protein(CRP)were significantly elevated after the infection.The result of multivariate logistic analysis showed that complication with diabetes mellitus,use of steel plate,operation duration more than 3 hours,open fracture and long length of incision were the risk factors for the postoperative incision infection in the patients with limb fracture(P<0.05).CONCLUSION The gram-positive bacteria are dominant among the pathogens isolated from the limb fracture patients with postoperative incision infection.The patients with the infection show the rise of inflammatery factors IL-6,PCT and CRP.The incidence of the postoperative incision infection is closely associated with the diabetes mellitus,use of steel plate,operation duration,open facture,incision,serum IL-6,PCT and CRP.It is necessary for the hospital to take targeted prevention and treatment measures based on the factors so as to reduce the risk of postoperative incision infection in the patients with limb fracture.
作者
李春梅
宋涛
刘鹏
孙洁
LI Chun-mei;SONG Tao;LIU Peng;SUN Jie(Shandong University Qilu Hospital(Qingdao),Qingdao,Shandong 266000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第9期1379-1382,共4页
Chinese Journal of Nosocomiology
基金
山东省卫生健康委科技计划项目(2020129)。
关键词
四肢骨折
术后感染
切口感染
病原菌
危险因素
Limb fracture
Postoperative infection
Incision infection
Pathogen
Risk factor
