14274例骨科无菌手术切口感染调查分析

目的：调查骨科无菌手术切口感染发生情况,探讨其预防措施。方法：采用回顾性调查研究方法,对2007年1月至2008年12月间14274例骨科无菌手术患者的切口感染情况进行调查分析。结果：14274例骨科无菌手术患者中发生切口感染133例;其中2007年5981例患者中发生切口感染78例,感染率为1.304%;2008年8293例患者中发生切口感染55例,感染率为0.663%;2008年无菌手术切口感染率低于2007年（χ2=15.4635,P〈0.0001）;2007年、2008年骨科无菌手术切口感染主要病原体中G＋球菌与G-杆菌的比例,差异无统计学意义（χ2=1.3549,P=0.2444）。结论：重视高危感染病例,减少待手术日数,合理应用抗菌药物,加强术中无菌及无创操作,进行手术医师切口感染专率监测,是降低骨科无菌手术切口感染率的有效措施;围手术期用药时,应根据病原体检测结果和药敏试验结果,选用对G＋球菌和G-杆菌均有效的抗菌药物。

An investigation of incision infection after orthopedic aseptic operation(14 274 cases report)

Objective:To investigate the cases of incision infection after orthopedic aseptic operation and discuss the prevention measures. Methods:14 274 patients from Jan 2007 to Dec 2008 were surveyed for retrospective analysis on incision infection after orthopedic aseptic operation. Results:Totally 133 incision infection cases were reported from 14 274 cases. 78 incision infection cases were reported from 5 981 cases in 2007 and the incision infection rate in this cohort was 1.304%, while 55 incision infection cases were reported from 8 293 cases in 2008 and the incision infection rate in this cohort was 0.663%. The rate of incision infection after orthopedic aseptic operation in 2008 was lower than that in 2007(χ2=15.463 5,P<0.000 1). On the other hand, there was no statistical difference between 2007 and 2008 on ratio of G+ cocci and G- bacillus which were major pathogens of incision infection after orthopedic aseptic operation(χ2=1.354 9, P=0.244 4).Conclusion:High-risk cases should be pay attention to, and the time before operation should be reduced, and the antibiotic should be used reasonably, and Aseptic and Non-invasive operation should be emphasized, and the ratio of incision infection should be monitored, and all these measures can reduce the ratio of incision infection after orthopedic aseptic operation. Perioperative medication should be based on results of pathogens detection and drug sensitivity test and those effective drugs against both G+ cocci and G- bacillus should be used.