摘要
目的 探讨分析髋部骨折患者院内感染发生情况以及其危险因素.方法 选择2020年1月至2023年1月保定市3家综合性医院的骨科住院手术治疗的髋部骨折患者为研究对象,收集患者疾病相关信息,并对其院内感染情况进行跟踪随访,采集疑似感染者生物样本用于病原菌培养及鉴定,采用描述分析法分析院内感染发生情况,并采用单、多因素分析方法对院内感染的危险因素进行分析.结果 本研究共纳入1012例患者,发生院内感染87例,院内感染发生率为8.60％,其中泌尿系统感染42例,肺部感染26例,手术切口感染10例,其他感染9例.87例院内感染患者的样本中培养出病原菌98株,其中革兰阳性菌30株(30.61％),革兰阴性菌67株(68.37％),真菌1株(1.02％).多因素logistic回归分析结果显示年龄(OR=1.581)、基础疾病(OR=1.442)、手术时间(OR=1.689)、术后卧床时间(OR=1.730)、术后住院时间(OR=1.530)、侵入性操作(OR=1.659)、术中异体输血(OR=1.436)、季节(OR=1.637)是髋部骨折患者院内感染的危险因素.结论 髋部骨折患者的院内感染发生率较高,且病原菌主要为革兰阴性菌,年龄、基础疾病、手术时间、术后卧床时间、术后住院时间、侵入性操作、术中异体输血、季节是髋部骨折患者院内感染的危险因素.
Abstract
Objective To investigate the incidence of nosocomial infection and its risk factors in patients with hip fracture.Methods Patients with hip fracture undergoing in-patient surgery in three general hospitals in Baoding City from January 2020 to January 2023 were selected for this study.Disease-related information was collected and nosocomial infections were followed up.Biological samples of suspected infected patients were collected for pathogen culture and iden-tification,and the incidence of nosocomial infections was analyzed by descriptive analysis.The risk factors of nosocomial in-fection were analyzed by univariate and multivariate analysis methods.Results A total of 1 012 patients were enrolled in this study,among whom 87 developed nosocomial infections(8.60％).These infections included 42 cases of urinary system infection,26 cases of pulmonary infection,10 cases of surgical incision infection,and 9 cases of other infections.Among the patients with nosocomial infections,a total of 98 strains of pathogenic bacteria were cultured:30 gram-positive bacte-ria(30.61％),67 gram-negative bacteria(68.37％),and one fungus(1.02％).Multivariate logistic regression analysis re-vealed that age(OR=1.581),underlying disease(OR=1.442),duration of surgery(OR=1.689),postoperative bed time(OR=1.730),postoperative hospital stay(OR=1.530),invasive procedures(OR=1.659),intraoperative allogeneic blood transfusion(OR=1.436),and seasonality factors(OR=1.637)were identified as risk factors for nosocomial infections in patients with hip fracture.Conclusions The incidence of nosocomial infection in patients with hip fracture is signifi-cantly high,predominantly attributed to gram-negative bacteria.Age,underlying disease,duration of surgery,postoperative bed time,postoperative hospital stay,invasive procedures,intraoperative allogeneic blood transfusion,and seasonality fac-tors are identified as risk factors for nosocomial infection in patients with hip fracture.
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