骨科手術切口感染相關因素及護理對策

論文編號:HL223 論文字數:11921,頁數:25

論文題目：骨科手術切口感染相關因素及護理對策
摘 要
 
 目的：探討導致骨科手術切口感染的影響因素，提出降低骨科手術切口感染率的護理對策。方法：以發生骨科手術切口感染68例患者為研究對象，采用目標監測性調查研究的方法，調查病人的一般資料、手術實施情況、易感因素以及手術相關的環境因素，然后對可能造成切口感染的因素逐步進行單因素回歸與多因素回歸。結果：手術前基本情況如患者年齡較大、男性、入住ICU、急診手術、住院‍天數長、術前天數長等因素與骨科手術切口感染顯著相關（P＜0.001）；骨科手術實施情況如切口類型、手術時間長、切口‍長度長、術中出血多與手術切口感染顯著相關（P<0.001)；抗菌藥物治療情況如術前抗菌藥物治療、術中抗菌藥物治療、術后抗菌藥物治療與手術切口感染顯著相關(P<0.001)。結論：高齡、住院天數長、入住ICU、急診手術、術前住院天數長、手術時間長、清潔污‍染切口、污染切口、切口長度長、抗菌藥物治療等是導致骨科手術切口感染的影響因素，通過改善患者自身狀況，合理使用抗菌藥物，重視手術期間護理，加強病房環境管理與消毒工作等有針對性的護理措施，可以降低切口感染率。
 
 關鍵詞：骨科；切口感染；護理
 

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 錄
1 緒論 1
1.1 背景及意義 1
1.2 研究目的及目標 1
1.2.1 研究目的 1
1.2.2 研究目標 1
1.3 關鍵詞定義 1
1.4 文獻回顧 2
2 研究設計 5
2.1 研究設計 5
2.2 研究對象 5
2.2.1診斷及分組標準 5
2.3 研究方法 5
2.3.1測查指標 6
2.4 統計學處理 6
3 結果 7
3.1骨科手術切口感染的流行特征 7
3.1.1骨科手術切口感染的發病率 7
3.1.2按手術切口類型分類的切口感染率 7
3.2抗菌藥物使用情況調查 7
3.3醫療環境與消毒滅菌物品檢測 8
3.4骨科手術切口感染影響因素分析 8
3.4.1手術前基本情況與手術切口感染的關系 8
3.4.2骨科手術實施情況與切口感染的關系 9
3.4.3抗菌藥物治療情況與骨科手術切口感染的關系 10
3.4.4骨科手術切口感染影響因素多因素分析‍ 11
4 討論 12
4.1骨科病人自身情況是發生切口感染的關鍵因素之一，應改善患者狀況 12
4.2使用抗菌藥物治療易導致骨科手術切口感染，應維持合理限度 12
4.3骨科手術實施實施情況與切口感染直接相關，應做好手術前后護理 13
4.4醫院環境與骨科手術切口感染密切相關，應加強環境管理工作 14
5 結論及建議 16
5.1 結論 16
5.2 建議 16
致    謝 17
參考文獻 18