【摘要】 目的探讨开放性骨折患者并发医院感染的临床特征以及预防措施,为降低医院感染发病率提供科学依据。方法回顾性分析2013年1月至2016年12月间因开放性骨折在我院接受治疗的420例患者的临床资料,分析其医院感染类型、病原菌分布及其影响因素。结果发生医院感染患者82例,感染率为19.52%,主要感染类型包括因交通事故引起的骨折、下肢骨折和GustiloⅢ型骨折,在其本类型中的构成比分别为32.93%、46.34%、51.22%;共检出病原菌82株,主要为革兰阴性菌、革兰阳性菌,构成比分别为57.32%、29.27%;多因素分析显示住院时间≥30 d、骨折部位为腰髋和下肢、病程≥15 d以及GustiloⅢ型是开放性骨折患者并发医院感染的危险因素(P<0.05)。结论开放性骨折并发医院感染率高,应根据病原菌培养结果及时、合理使用抗菌药物,以缩短住院时间。更多还原

【Abstract】 Objective To investigate the clinical features and preventive measures of nosocomial infections in patients with open fractures and to provide a scientific basis for reducing the incidence of nosocomial infections.Methods The clinical data of 420 patients with open fractures treated in our hospital from January2013 to December 2016 were retrospectively analyzed.The types of hospital infection,the distribution of pathogens and their influencing factors were analyzed.Results 82 cases of nosocomial infection occurred,with an infection rate of 19.52%.The main types of infections included the fractures caused by traffic accidents,lower extremity fractures and Gustilo type III fractures,with the proportions of 32.93%and46.34%51.22%;82 pathogenic bacteria were detected,mainly gram-negative bacteria,Gram-positive bacteria,the constituent ratios were 57.32%,29.27%respectively;Multivariate analysis showed that the hospitalization time was≥30 days,≥15 d and Gustilo type III were risk factors of nosocomial infection in patients with open fractures(P<0.05).Conclusion Open fracture complicated by high nosocomial infection should be based on the results of pathogen culture in a timely and rational use of antimicrobial agents to reduce hospitalization time.更多还原