摘要
目的:以Logistic回归分析探讨四肢深度烧伤患者创面感染的危险因素,并提出预防建议。方法:对2013年8月-2018年5月收治的四肢深度烧伤患者共120例的临床资料展开回顾,统计创面感染的发生例数和发生率,总结可能的危险因素并对比发生感染者和未发生感染者间差异,以Logistic回归分析探讨其危险因素。结果:本组患者中创面感染率为16.67%(20/120),其中革兰阴性菌、革兰阳性菌、真菌的构成比分别为51.16%、44.19%、4.65%;发生感染者Ⅲ度烧伤、合并糖尿病、营养不良、家属手卫生依从性差、入院至修复手术时间>1周、手术时间>2h、术后残余创面、联合使用抗生素构成比均高于未发生感染者,差异有统计学意义(P<0.05);均经Logistic回归分析证实为危险因素(OR=6.560、7.199、5.171、9.757、4.988、6.443、4.183、4.983,P<0.05)。发生感染者术后负压引流构成比低于未发生感染者(P<0.05),经Logistic回归分析证实为保护因素(OR=0.475,P<0.05);两者年龄、烧伤面积、预防性使用抗生素时间分布对比差异均有统计学意义(P<0.05),且经Logistic回归分析证实年龄<16岁、年龄≥60岁、烧伤面积≥20%且<40%、烧伤面积≥40%、预防性使用抗生素时间≥3d且<10d、预防性使用抗生素时间≥10d均为危险因素(OR=6.092、7.287、7.207、14.629、5.063、6.653,P<0.05)。结论:四肢深度烧伤患者创面感染的风险高,革兰阴性菌和革兰阳性菌均较为常见,年龄<16岁、年龄≥60岁、Ⅲ度烧伤等均是其危险因素,术后负压引流是其保护因素。
Objective Logistic regression analysis was used to explore the risk factors of wound infection in patients with deep burn of extremities, and preventive suggestions were put forward. Methods The clinical data of 120 patients with deep burn of extremities admitted from August 2013 to May 2018 were reviewed. The incidence and incidence rate of wound infection were counted. The possible risk factors were summarized and the differences between the occurrence and non-occurrence were compared. The risk factors were discussed by logistic regression analysis. Results The infection rate of wounds in this group was 16.67%(20/120), and the proportions of gram-negative bacteria, Gram-positive bacteria and fungi were 51.16%, 44.19% and 4.65% respectively. The proportions of Ⅲ degree burns, diabetes mellitus, malnutrition and poor hand hygiene compliance of the family members, time from admission to repair surgery >1 week, operation time >2 h, residual wound after operation, combined use of antibiotics in the patients were higher than those in the non-patients(P<0.05). The risk factors were confirmed by logistic regression analysis(OR=6.560, 7.199, 5.171, 9.757, 4.988, 6.443, 4.183, 4.983, P<0.05). The application ratio of negative pressure drainage after operation in the patients was lower than that in the non-patients(P<0.05). Logistic regression analysis confirmed that it was a protective factor(OR=0.475, P<0.05). There were significant differences in age, burn area and time distribution of prophylactic use of antibiotics between the incidence patients and non-incidence patients(P<0.05). Logistic regression analysis confirmed that the risk factors were age <16, age≥60, burn area<20% and <40%, burn area more than or equal to 40%, preventive use of antibiotics <3 d and <10 d, and preventive use of antibiotics <10 d(OR=6.092, 7.287, 7.207, 14.629, 5.063, 6.653, P<0.05). Conclusion Patients with deep burn of extremities are at high risk of wound infection, and gram-negative bacteria and gram-positive bacteria are common. Age <16 years old, age ≥60 years old, degree Ⅲ burns and so on are risk factors, while the application of negative pressure drainage after operation is its protective factor.
作者
张坤
ZHANG Kun(Department of Burn and Plastic Microsurgery,NO.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000,Shaanxi,China)
出处
《中国美容医学》
CAS
2020年第3期99-102,共4页
Chinese Journal of Aesthetic Medicine
关键词
深度烧伤
四肢
创面感染
危险因素
预防
deep burns
extremities
wound infection
risk factors
preventive
作者简介
张坤(1971.6-),男,本科,副主任医师,主要从事创面修复研究,E-mail:zhxcztg@163.com。
