摘要
目的分析骨科术后感染潜在危险因素以及诊断标准,掌握骨科术后感染的病原菌种类和耐药情况,了解抗生素骨水泥在骨科术后感染中的使用情况。方法对84例骨科术后感染患者的临床资料进行回顾性调查分析。结果在选取的84例骨科术后感染患者中,骨科手术有异物植入的患者占感染总人数的76.19%;对于骨科术后感染的诊断除细菌培养外,C反应蛋白和血沉也表现出较高的灵敏性;培养出病原菌94株,其中革兰阳性菌占总菌株数的67.02%,革兰阴性菌占31.91%,真菌占1.06%;药敏结果显示,常用抗菌药物耐药率较高;抗生素骨水泥植入是治疗关节感染的常用手段。结论骨科术后感染的危险因素包括异物植入、高龄、慢性疾病、烟酒不良嗜好等;细菌培养结果可以作为诊断术后感染的标准,血沉、白细胞计数、中性粒细胞百分比、C反应蛋白等也作为临床诊断感染的依据,尤其是ESR和CRP表现出较高的灵敏性;医务工作者要尽可能在药敏结果的指导下合理选用抗菌药物,减缓病原菌耐药性的增长。
Objective To analyze the potential risk factors for infection and the diagnostic criteria after orthopedic surgery,master the type of pathogen of infection and drug resistance,and acknowlege the use of antibiotic bone cement in the infection.Methods The clinical data of 84 patients infected after surgery in department of orthopedics were retrospectively analyzed.Results Bone surgery patients with foreign implanted accounted for 76.19%of the total number of infections.C reactive protein and erythrocyte sedimentation rate also showed higher sensitivity for the diagnosis of bacterial infection after surgery.Among 94 strains of pathogens,there were 67.02%of gram positive bacteria,31.91%of gram negative bacteria,1.06%of fungi.The drug sensitivity showed that drug resistance rate of commonly used antibacterial drugs was higher;Antibiotic bone cement implantation was a common means of treatment for joint infections.Conclusion The risk factors of infection after surgery in the department of orthopedics include foreign matter implantation,age chronic disease,smoking and so on.Nowadays the results of bacterial culture can be used at diagnostic criteria of postoperative infection,besides,erythrocyte sedimentation rate（ESR）,white blood cell count,the neutrophil cell percentage,and C reactive protein（CRP） can also be used in the diagnosis of infection crite（especially for ESR and CRP）.We should reasonably use antimicrobial drugs as far as possible under the guidance of the drug sensitivity results,and slow down the growth of drug resistance of pathogenic bacteria.
出处
《实用药物与临床》
CAS
2016年第1期58-61,共4页
Practical Pharmacy and Clinical Remedies
关键词
骨科术后感染
危险因素
诊断
病原菌
抗生素骨水泥
Orthopaedic postoperative infection
Risk factors
Diagnose
Pathogen
Antibiotic-loaded bone cement
