【摘要】 目的探讨胫腓骨开放性骨折创口感染的病原学研究及预防措施,为今后的临床工作提供有价值的参考信息。方法收集2014年7月~2016年1月在我院接受治疗的56例胫腓骨开放性骨折患者的临床资料,对患者的感染情况进行统计分析,展开病原菌的分离、鉴定和药敏试验,总结针对性干预措施。结果在接受调查的56例患者中,共检出创口感染者4例,感染发生率为7.14%;经病原菌检测,共分离得到病原菌株7株,包括革兰阳性菌和革兰阴性菌,前者所占比例高于后者(P<0.05);金黄色葡萄球菌、凝固酶阴性葡萄球菌等对临床常用万古霉素等抗生素的耐药性较低,大肠埃希菌、铜绿假单胞菌对头孢哌酮/舒巴坦的耐药性相对较低。结论胫腓骨开放性骨折患者的创口感染发生率较低,发生风险较大,病原菌以革兰阳性菌为主,在今后的临床工作中,应注意加强无菌操作,对耐药菌进行严密监控,合理应用抗生素,以降低创口感染发生率,改善临床治疗效果,提高临床医疗质量。更多还原

【Abstract】 Objective To investigate the etiological study and preventive measures of wound infection in patients with open fracture of tibia and fibula so as to provide valuable reference information for future clinical work.Methods The clinical data of 56 patients with open fractures of tibia and fibula who were treated from July 2014 to January 2016 in our hospital was collected and their infection conditions were statistically analyzed;then,isolation,identification and drug susceptibility test of pathogens were performed to summarize the targeted intervention measures.Results Among 56 patients that were involved in the survey,there were 4 cases of wound infections,with the infection rate accounting for 7.14%;according to the pathogen detection results,7 strains of pathogens were isolated,including Gram-positive and Gram-negative bacteria,the proportion of the former was higher than that of the latter(P<0.05).Staphylococcus aureus and Coagulase negative staphylococci had low drug resistance on clinically commonly-used antibiotics such as Vancomycin;Escherichia coli and Pseudomonas aeruginosa had relatively low drug resistance on Cefoperazone/Sulbactam.Conclusion Patients with open fractures of tibia and fibula have low incidence but great risk of wound infections,mostly with Gram-positive bacteria as the pathogens.In the future clinical work,great attention should be paid to strengthened aseptic operation,close monitoring of drug-resistant bacteria and rational use of antibiotics so as to reduce the incidence of wound infections and to improve the clinical therapeutic effect and the quality of clinical medical care.更多还原