王亚慧+杨江波+郭丽珍

【摘要】 目的：通过对股骨颈修复患者开展手术部位感染目标性监测，了解手术部位感染发生率和相关危险因素，以便采取有效控制措施，降低感染发生率。方法：采用前瞻性监测方法，对2015年行股骨颈修复的203例患者进行监测，统一填写调查表，所得数据采用SPSS 19.0软件进行统计分析。结果：共监测203例患者，其中4例发生手术部位感染，感染率为1.97%。手术危险指数主要集中在0级和1级，手术部位感染发生率分别为0.56%和13.04%；手术部位感染以表浅切口感染为主，占75.00%；感染病原菌均为条件致病菌。术前住院天数、手术切口类型、麻醉评分、手术持续时间、手术危险指数、围术期抗菌药物使用与手术部位感染密切相关（P<0.05）。结论：术前住院天数、手术切口类型、麻醉分级、手术持续时间、手术危险指数、围术期抗菌药物使用等与手术部位感染的发生密切相关，应针对这些危险因素，采取适当的干预措施，从而降低手术部位感染发生率。

【关键词】 股骨颈修复； 手术部位感染； 目标性监测； 危险因素

【Abstract】 Objective：To investigate the status of surgical site infection rate and the risk factors for femoral neck repair through the objective monitoring，in order to take effective measures to reduce the infection rate of surgical site infection.Method：Prospective method was used for 203 femoral neck surgical patients in 2015，fill the unified forms，the statistical analysis was performed by using SPSS 19.0 software.Result：A total of 203 cases of femoral neck repair surgical，surgical site infection occurred in 4 cases，the infection rate was 1.97%.National Nosocomial Infection Surveillance （NNIS） mainly concentrated in the 0 and 1 point，and the infection rates were 0.56% and 13.04%.The main postoperation incision infections were superficial infections，its infection rate was 75.00%.All infection of pathogenic bacteria were opportunistic pathogen.Preoperative hospital days，surgical incision type，anesthesia score，duration of operation，operative risk index，perioperative use of antimicrobial agents and surgical site infection were closely related（P<0.05）.Conclusion：Preoperative hospital days，surgical incision type，anesthesia score，duration of operation，operative risk index，perioperative use of antimicrobial agents and surgical site infection are closely related，appropriate interventions should be taken to reduce the incidence of surgical site infection.

【Key words】 Femoral neck repair； Surgical site infection； Objective monitoring； Risk factor

First-authors address：Shanxi Medical University，School of Public Health，Taiyuan 030001，China

doi：10.3969/j.issn.1674-4985.2016.36.016

手術部位感染是骨科手术主要的并发症之一，也是骨科病房常见的医院获得性感染[1]。各科室手术部位感染率中，以骨外科最高（5.48%），主要为外伤开放性骨折的患者[2]。手术部位感染监测室实施医院感染管理、开展医院感染防控的核心内容和基本手段[3]。为了寻找股骨颈修复患者手术部位感染的相关危险因素，对某三级综合医院2015年行股骨颈修复的203例患者进行了前瞻性监测与分析，现将监测结果报告如下。

1 资料与方法

1.1 一般资料 2015年行股骨颈修复的患者共计203例，其中股骨颈骨折切开复位内固定98例，全髋关节置换术42例，人工股骨头置换术63例，全部为择期手术，其中男102例，女101例，年龄15～86岁，平均（57.34±21）岁；……