老年患者骨科手术切口感染危险因素分析及防治对策.docVIP

老年患者骨科手术切口感染危险因素分析及防治对策 　　[摘要]目的 探讨老年患者骨科手术切口感染的危险因素，分析此类危险因素的防治对策。方法 回顾性分析2015年1月～2017年1月于我院接受骨科手术治疗的480位老年患者的临床资料。对患者的的一般资料、手术情况、切口感染病原菌分布及抗菌药物使用情况等进行分析，对老年患者骨科手术切口感染的危险因素进行分析，并归纳总结相应的预防对策。结果 480例老年患者中共26例患者发生手术切口感染，感染病原菌以革兰阳性菌金黄色葡萄球菌为主，占65.38%。截肢术患者术后切口感染率最高，为30.00%。此外，年龄≥65 岁、手术耗时≥3h、住院时间≥14d、预防性使用抗菌药物48h、Ⅲ型切口以及患者有基础疾病史均可能为造成老年患者骨科手术切口感染的危险因素（P0.05）。结论 导致老年患者骨科手术切口感染的影响因素较多，在对此类患者实施骨科手术治疗时，为预防感染的发生，医护人员应给予预防性的干预措施，尽可能避免发生手术切口感染，促进患者预后。 　　[关键词]老年；骨科；手术切口；感染； 危险因素；防治 　　[中图分类号] R687 [文献标识码] A [文章编号] 2095-0616（2017）15-252-03 　　[Abstract]Objective To investigate the risk factors of surgical incision infection of elderly patients in Department of orthopedics， and to analyze the prevention and treatment measures of these risk factors. Methods The clinical data of 480 elderly patients treated in Department of orthopedics of our hospital from January 2015 to January 2017 were analyzed retrospectively. The general information， the operation condition， the distribution of pathogens and the usage of antibiotics were analyzed， the risk factors of incision infection of elderly patients in Department of orthopedics were analyzed， and the corresponding preventive measures were summed up. Results Of the 480 elderly patients，26 elderly patients had surgical incision infection. The main pathogens were gram positive bacteria and Staphylococcus aureus， accounting for 65.38% of the total.The rate of incision infection in amputation patients was the highest， with 30%. In addition， 65 years old or older， operation time≥3h， hospitalization time≥14d， the prophylactic use of antibiotics 48h， type III incision and underlying basic diseases were likely to cause orthopedics incision infection factors in elderly patients（P0.05）. Conclusion Many factors can cause orthopedics operation incision infection in elderly patients treated in Department of orthopedics， In the implementation of surgical treatment for such patients， in order to prevent infection， preventive intervention measures sho