烧伤整形术后感染的危险因素分析及诊治对策

目的 分析烧伤整形术后患者发生感染的相关危险因素,并提出诊断与治疗对策.方法 选择铜川市矿务局中心医院2011年1月至2012年12月收治的46例有感染症状的烧伤整形术后患者作为感染组,并随机选择同期80例无感染症状的烧伤整形患者作为对照组,分析引发感染的相关危险因素,提出诊治对策.结果 使用二种以上抗生素、手术时间＞180 min、创面有瘢痕皱褶凹凸、有创面及整形手术后半年内为烧伤整形术后发生感染的独立危险因素（P＜0.05）.对46例烧伤整形术后感染患者分泌物进行培养,共培养分离出46株病原菌,以革兰阴性菌为主,共30株,占65.22%,革兰阳性菌16株,占34.78%.前三位的感染病原菌分别为铜绿假单胞菌、金黄色葡萄球菌及大肠埃希菌.结论 对感染部位分泌物取样培养,积极采取针对性的治疗,同时对高危因素进行针对性干预,可降低感染率,促进患者早日康复.

Burn Plastic Surgery Postoperative Infection Risk Factor Analysis and the Diagnosis and Treatment Countermeasures

Objective To analyze the infection-related risk factors for burns plastic surgery patients, and propose the diagnosis and treatment countermeasures. Methods From Tongchuan Mining Bureau Central Hospital, during January 2011 and December 2012,46 cases treated with infection in burn patients after plas-tic surgery were selected as infection group and 80 cases of non-infected patients with symptoms of burns and plastic surgery of the same period were randomly selected as the control group, and infectinn-related risk factors were analyzed,and the diagnnsis and treatment eountermeasores were proposed. Results Use of two of two or more antibiotics,operation time 〉 180 min, wound sear folds bump, with wound residue, and within six months after plastic： surgery were risk faetors for postoperative infection （ P 〈 0.05 ）. Secretions of 46 cases of infected burns and plastic surgery patients were cultured, and 46 pathogens were isolated, mainly Gram-negative, with a total of 30 cases, accounting for 65.22 %, Gram-positive bacteria was in 16 cases, accounting for 34.78%. The top three infectious pathogens were Pseudomonas aeruginosa, Staphylococcus aureus and Escheriehia coll. Conclusion The cuhure of secretions from the site of infection sampling, and actively taking targeted therapy ,while giving targeted interventions into the risk factors can reduce infection rates and promote early recovery of patients.