烧伤患者切痂植皮术后感染的危险因素分析及防治策略

陈永峰，王大洪，王爱武

（1 .陕西省勉县医院外科，陕西 汉中，724200 ；2 .陕西省汉中市中心医院烧伤整形科，陕西 汉中，723000）

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摘要：

目的 观察烧伤患者切痂植皮后感染的危险因素，并探讨防治对策。方法 选取139例切痂植皮术后发生了不同程度感染的患者，与139例切痂植皮术后未感染者进行对比，分析导致术后感染的主要危险因素，并提出防治对策。结果 手术时间>3 h、备皮时间>3 h、有瘢痕褶皱、残留创面、使用2种以上抗生素、住院时间多于2周是造成切痂植皮后感染的主要影响因素；对139例术后感染患者的分泌物进行细菌培养，结果显示G-球菌是主要感染菌，其次为G+球菌、铜绿假单胞菌。结论 对烧伤患者切痂植皮后的感染高危因素进行干预，同时对烧伤植皮后感染患者的分泌物取样培养，分析主要感染菌， 并制定针对性治疗方案，可有效降低烧伤切痂植皮后的感染率，提高植皮质量。

关键词：切痂植皮；感染；危险因素

中图分类号：R644文献标志码：A文章编号：2096-1413(2017)09-0079-02

Risk factors and strategies for the prevention and treatment of burn patients after infection

of the tangential excision and skin grafting
CHEN Yong-feng 1, WANG Da-hong 1, WANG Ai-wu 2
(1. Department of Surgery, Mianxian County Hospital, Hanzhong 724200; 2. Department of Bums and Pladtic Surgery,

Hanzhong Central Hospital, Hanzhong 723000, China)

ABSTRACT: Objective To observe the risk factors of infection in burn patients after tangential excision and skin grafting, and discuss the control strategies. Methods One hundred and thrity-nine cases of escharectomy postoperative infection in different degrees were selected as the observation group, and were compared with the patients who had no escharectomy postoperative infection (control group). The major risk factors of postoperative infection were investigated, so as to put forwards countermeasures to the corresponding factors. Results The operative time and skin preparation time more than 3 hours, scar fold, residual wound, hospitalization time more than 2 weeks, and more than two kinds of antibiotics use were the main facters causing infection after escharectomy; after cultivation of secreta bacterial of 139 cases after operation, it showed that G-aureus was the main infectious bacteria, followed by G+aureus and pseudomonas aeruginosa bacteria. Conclusion Taking intervention measures in the risk factors for the patients after tangential excision and skin grafting, and cultivating the secretion bacterial to develop targeted therapies, can significantly reduce infection rate, and improve skin quality.
KEYWORDS: escharectomy; infection; risk factors

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