骨科关节术后医院感染的相关危险因素分析

Analysis of Nosocomial Infection Risk Factors after Orthopedic Joint Surgery

摘要: 目的：对骨科关节术后医院感染的相关危险因素做分析。方法：本研究采用回顾性调查方法，从医院病案系统中调取2016年1月至2018年12月期间所有骨科关节手术患者信息；然后从医院感染实时监控中找出期间骨科关节术后感染患者，翻阅原始病例对其进行核实，并登记至《骨科手术患者术后感染个案调查表》中，调查内容包括：患者一般情况、手术相关情况、医院感染情况、病原学检查内容、感染后抗生素使用情况等。结果：该院2016年1月至2018年12月行骨科关节手术患者共8214例，其中出现术后感染为78例，术后医院感染发病率为0.74%，主要感染部位为上下呼吸道、泌尿道；术后感染的病原菌主要为革兰阳性菌，以金黄色葡萄球菌和凝固酶阴性葡萄球菌多见；患者高龄、手术时间长、术中出血量多、引流时间长、有无并发症、长期应用激素、合并糖尿病是骨关节术后感染相关因素。结论：在临床工作中应更多关注高龄、手术时间长、引流时间长、并发症、合并糖尿病患者术后感染情况。

Abstract: Objective: To analyze the risk factors nosocomial infection after orthopedic joint surgery. Methods: In this research, retrospective survey was conducted to collect information in hospital medical record system on patients undergoing joint surgery in department of orthopedics from January 2016 to December 2018, then find out patients with postoperative infection in orthopedics department from the real-time monitoring of infection, check the original case and register in the questionnaire of postoperative infection cases of orthopedic patients. The research includes general condition of patients, operation-related information, nosocomial infection, etiological examination contents, the use of antibiotics after infection, etc. Results: From January 2016 to December 2018, there were 8214 patients in our hospital including 78 cases of postoperative infection, the incidence rate of postoperative infection was 0.74%. The main infection sites were upper and lower respiratory tract, urinary tract. The main pathogens of postoperative infection were Gram-positive bacteria, mainly Staphylococcus aureus and coagulase negative Staphylococcus. Advanced age, operative duration, more bleeding during operation, long drainage time, complications, long-term hormone use, and diabetes mellitus are the related factors of postoperative infection. Conclusion: In clinical work, we should pay more attention to the postoperative infection of old patients, patients with long duration of operation, patients with long duration of drainage, patients with complications and patients with diabetes.