烧伤整形术后感染的危险因素与对策分析.docVIP

烧伤整形术后感染的危险因素与对策分析 　　 　　[摘要]目的：探讨烧伤整形术后感染的危险因素及预防对策。方法：选取烧伤整形术后感染者53例作为感染组及50例未感染者为对照组，分析术后感染的危险因素及预防对策。结果：多因素Logstic回归分析表明，联合使用2种及以上抗生素（OR=2.622，P＜0.05），手术时间≥200min（OR=2.800，P＜0.05），术后有瘢痕（OR=3.433，P＜0.05），术后有残余创面（OR=2.703，P＜0.05）均为烧伤整形术后院内感染的独立危险因素。烧伤整形术后感染的主要病原菌为金黄色葡萄球菌（26.42%）、铜绿假单胞菌（30.19%）及大肠埃希菌（20.75%）。结论：烧伤整形术后感染的危险因素主要包括抗生素使用种类过多、手术时间过长及瘢痕及残余创面，合理使用抗生素、缩短手术时间及消除瘢痕及残余创面可作为烧伤整形术后感染的预防对策。 　　[关键词]烧伤；整形；感染；因素；对策 　　[中图分类号]R644 [文献标识码]A [文章编号]1008-6455（2014）05-0348-03 　　 　　The risk factors and countermeasures of patients of burns plastic postoperative infection 　　CHEN Cong-bai 　　(Department of Plastic Surgery,Tianmen First Peoples Hospital,Tianmen 431700,Hubei,China) 　　 　　Abstract:ObjectiveTo investigate the risk factors and countermeasures of patients of burns plastic postoperative infection.Methods53 cases of patients of burns plastic postoperative infection were chosed as the infection group and another 50 ases of patients of burns plastic postoperative non-infection were chosed as the control group, and the risk factors and preventive measures were analyzed.ResultsThe Logstic multivariate regression analysis showed that joint use of two kinds or more antibiotics (OR=2.622,P0.05),operation time ≥ 200min (OR=2.800, P0.05), postoperative scar(OR=3.433,P0.05) and postoperative residual wounds (OR=2.703, P0.05) were the independent risk factors of nosocomial infection.The major pathogens were staphylococcus aureus (26.42%),pseudomonas aeruginosa (30.19%) and escherichia coli (20.75%). ConclusionBurns plastic postoperative infection risk factors include the type of excessive use of antibiotics,prolonged surgery time and residual wound and scar.Rational use of antibiotics, desrease the operation time and eliminate the scarring and residual of wounds could as the countermeasures for plastic surgery infection. 　　Key words:burns;shaping;infection;factors;countermeasures烧伤整形术后感染为为临床较为常见的院内感染，加之患者手术创面较大、手术切口较多，皮瓣组织抗感染的能力显著下降，一旦发生感染可导致皮瓣组织坏死、整形手术失败等严重不良后果[1-2