骨科手术切口感染相关因素及护理对策

论文编号:HL223 论文字数:11921,页数:25

论文题目：骨科手术切口感染相关因素及护理对策
摘 要
 
 目的：探讨导致骨科手术切口感染的影响因素，提出降低骨科手术切口感染率的护理对策。方法：以发生骨科手术切口感染68例患者为研究对象，采用目标监测性调查研究的方法，调查病人的一般资料、手术实施情况、易感因素以及手术相关的环境因素，然后对可能造成切口感染的因素逐步进行单因素回归与多因素回归。结果：手术前基本情况如患者年龄较大、男性、入住ICU、急诊手术、住院‍天数长、术前天数长等因素与骨科手术切口感染显著相关（P＜0.001）；骨科手术实施情况如切口类型、手术时间长、切口‍长度长、术中出血多与手术切口感染显著相关（P<0.001)；抗菌药物治疗情况如术前抗菌药物治疗、术中抗菌药物治疗、术后抗菌药物治疗与手术切口感染显著相关(P<0.001)。结论：高龄、住院天数长、入住ICU、急诊手术、术前住院天数长、手术时间长、清洁污‍染切口、污染切口、切口长度长、抗菌药物治疗等是导致骨科手术切口感染的影响因素，通过改善患者自身状况，合理使用抗菌药物，重视手术期间护理，加强病房环境管理与消毒工作等有针对性的护理措施，可以降低切口感染率。
 
 关键词：骨科；切口感染；护理
 

Title：Analysis of the Related Factors and Nursing Strategy of Incision Infection of Orthopedic Operation
                             ABSTRACT
     Objective: To investigate the related factors of incision infection of orthopedic operation and present the nursing strategy of decreasing its infection rate. Methods: We take 68 cases patients of incision infection of orthopedic operation as research object and adopt investigation of target monitoring to investigate the general information  and surgery implementation and susceptible factors and surgery environmental factors of patients. Then we gradually conduct the single-element regression and multi-element regression to the factors that might cause incision infection. Results: There were significant correlation(P＜0.001) between incision infection of orthopedic operation and basic situation before operation such as elder patients(>60), male,  ICU patients, emergency operation, more hospitalization days, more preoperative days; There were significant correlation(P＜0.001) between incision infection and the implementation of orthopedic operation such as incision type, long operation time, intraoperative hemorrhage; There were significant correlation(P＜0.001) between incision infection and antibiotic treatment such as preoperative antibiotic treatment,  intraoperative antibiotic treatment and postoperative antibiotic treatment. Conclusion: Senility, more hospitalization days, emergency operation, more preoperative days, long operation time, clean contaminated cuts, contaminated cuts, long incision length and antibiotic treatment are the  related factors of incision infection of orthopedic operation. We can decrease the infection rate by taking pertinently nursing strategies such as improving the self-condition of patients, rationally using antibiotics, emphasizing the intraoperative nursing and strengthening the ward environment management and disinfection work.
 KEY WORD: orthopaedics,incision infection,nursing
目 录
1 绪论 1
1.1 背景及意义 1
1.2 研究目的及目标 1
1.2.1 研究目的 1
1.2.2 研究目标 1
1.3 关键词定义 1
1.4 文献回顾 2
2 研究设计 5
2.1 研究设计 5
2.2 研究对象 5
2.2.1诊断及分组标准 5
2.3 研究方法 5
2.3.1测查指标 6
2.4 统计学处理 6
3 结果 7
3.1骨科手术切口感染的流行特征 7
3.1.1骨科手术切口感染的发病率 7
3.1.2按手术切口类型分类的切口感染率 7
3.2抗菌药物使用情况调查 7
3.3医疗环境与消毒灭菌物品检测 8
3.4骨科手术切口感染影响因素分析 8
3.4.1手术前基本情况与手术切口感染的关系 8
3.4.2骨科手术实施情况与切口感染的关系 9
3.4.3抗菌药物治疗情况与骨科手术切口感染的关系 10
3.4.4骨科手术切口感染影响因素多因素分析‍ 11
4 讨论 12
4.1骨科病人自身情况是发生切口感染的关键因素之一，应改善患者状况 12
4.2使用抗菌药物治疗易导致骨科手术切口感染，应维持合理限度 12
4.3骨科手术实施实施情况与切口感染直接相关，应做好手术前后护理 13
4.4医院环境与骨科手术切口感染密切相关，应加强环境管理工作 14
5 结论及建议 16
5.1 结论 16
5.2 建议 16
致    谢 17
参考文献 18