地震创伤患者感染流行病学分析
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摘要
目的探讨地震创伤患者感染的特征及其影响因素。方法对某院2008年5月16日—8月20日收治的140例地震伤员相关感染情况进行前瞻性调查分析。结果140例地震伤员感染的发生率为40.71%(57/140),其中医院感染发生率为28.57%(40/140)。分离到的88株感染病原菌中,以革兰阴性菌为主(占57.09%);从伤口分离出5株厌氧菌。创伤AIS-ISS分值与感染有密切关系,ISS分值越高,感染率也越高(χ2=13.12,P<0.05)。结论感染是地震创伤后的常见并发症,认真对伤员进行地震伤情分值计算以预测医院感染的发生,采取积极有效的预防和干预措施控制创伤感染非常必要。
Objective To study the characteristics and risk factors of infections in patients with earthquake injury. Methods Infections from 140 patients who were injured in Wenchuan earthquake and admitted in a hospital from May 16 to August 20, 2008 were analyzed by prospective study. Results The infection rate of 140 patients was 40.71% (57/140) and nosocomial infection rate was 28.57%(40/140) in patients with earthquake injury. Gram-negative bacilli were the main pathogens among 88 strains of pathogens in infection, which accounting for 57.09%; 5 strains of anaerobic bacteria were isolated from wound. Infection had a significant correlation with AIS-ISS score, the higher AIS-ISS score was, the higher rates of infections were. Conclusion Infection is a common complication of earthquake injury, it is necessary to analyze AIS-ISS score for predicting the occurrence of nosocomial infection, and take effective measures to prevent and control traumatic infection.
Objective To study the characteristics and risk factors of infections in patients with earthquake injury. Methods Infections from 140 patients who were injured in Wenchuan earthquake and admitted in a hospital from May 16 to August 20, 2008 were analyzed by prospective study. Results The infection rate of 140 patients was 40.71% (57/140) and nosocomial infection rate was 28.57%(40/140) in patients with earthquake injury. Gram-negative bacilli were the main pathogens among 88 strains of pathogens in infection, which accounting for 57.09%; 5 strains of anaerobic bacteria were isolated from wound. Infection had a significant correlation with AIS-ISS score, the higher AIS-ISS score was, the higher rates of infections were. Conclusion Infection is a common complication of earthquake injury, it is necessary to analyze AIS-ISS score for predicting the occurrence of nosocomial infection, and take effective measures to prevent and control traumatic infection.
引文
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[9]Parker M M.Critical care and disaster management[J].Crit Care,2006,34(1):52-55.
[2]中华人民共和国卫生部.医院感染诊断标准(试行)[S].北京,2001.
[3]高劲谋.多发伤和创伤评分[J].中华创伤杂志,2007,23(3):161-163.
[4]张凤云,粱艳芳.颅脑创伤患者术后继发肺部感染临床分析[J].中华医院感染学杂志,2006,16(3):274-276.
[5]Uckay I,Sax H,Harbarth S,et al.Multi-resistant infections in repatriated patients after natural disasters:lessons learned fromthe2004tsunami for hospital infection control[J].J Hosp Infect,2008,68(1):1-8.
[6]刘中民.改善急救模式提高创伤救治水平[J].中华急诊医学杂志,2002,4(11):79-80.
[7]王基.创伤感染中的医源性问题[J].创伤外科杂志,2007,9(1):1-3.
[8]吴安华.地震灾害紧急医疗救援中有关医院感染控制的十大要点[J].中国感染控制杂志,2008,7(4):221-224.
[9]Parker M M.Critical care and disaster management[J].Crit Care,2006,34(1):52-55.
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