67例疑似气性坏疽地震伤员院内交叉感染控制分析
|
摘要
目的探索地震伤员中疑似气性坏疽患者医院交叉感染控制途径方法2008年5月14日至6月24日,华西医院通过预检分诊、科学分期,优化地震伤员的接诊收治流程,科学管理开放性伤口,筛选疑似气性坏疽患者,实施手术消毒隔离处理,将预防控制疫情前移:用3%过氧化氢溶液冲洗、湿敷;对已缝合的伤口,拆去缝线,彻底清创,再给予抗菌药物治疗结果截至6月24日共收治疑似气性坏疽67例,其中高度疑似气性坏疽共32例,经厌氧细菌培养确诊气性坏疽5例,无1例因气性坏疽死亡,也无1例气性坏疽病例发生院内交叉感染32例中有26例已痊愈出院,尚有6例仍在住院治疗中结论科学管理与治疗得当是控制疑似气性坏疽患者医院感染的良好途径
Objective To find effective ways for controlling the hospital infection to the skeptical gas gangrene patients.Method From May 14th to June 24th,the hospital set up triage spots originally and dealt with the wounded based on their specific conditions in different stages and optimized the flow of admission of the wounded.Owing to correctly treating the wound and screening the skeptical gas gangrene patients,preventing nosocomial infections was shifted forward.Sprending the gas gangrene wound after having flushed it with 3%H 2 O 2 .If the wound have been stitched,the stitches should bee taken out,and open the wound and take the debridement for it completely,then treat it with strong antibacterial after debridement by sterilization and isolation about operation of gas gangrene.Result Up to June 24th,none of 67 cases of doubtful gas gangrene from the disaster area died and no hospital cross infections happened in courtyard.At present,amomg the 67 cases,32 were highly suspected of gas gangrene infection,26 cases were discharged,while 6 cases were undergoing treatment in the hospital.Conclusion Correct management and appropriate treatment are effective ways for controlling hospital cross infection to the skeptical gas gangrene patients.
Objective To find effective ways for controlling the hospital infection to the skeptical gas gangrene patients.Method From May 14th to June 24th,the hospital set up triage spots originally and dealt with the wounded based on their specific conditions in different stages and optimized the flow of admission of the wounded.Owing to correctly treating the wound and screening the skeptical gas gangrene patients,preventing nosocomial infections was shifted forward.Sprending the gas gangrene wound after having flushed it with 3%H 2 O 2 .If the wound have been stitched,the stitches should bee taken out,and open the wound and take the debridement for it completely,then treat it with strong antibacterial after debridement by sterilization and isolation about operation of gas gangrene.Result Up to June 24th,none of 67 cases of doubtful gas gangrene from the disaster area died and no hospital cross infections happened in courtyard.At present,amomg the 67 cases,32 were highly suspected of gas gangrene infection,26 cases were discharged,while 6 cases were undergoing treatment in the hospital.Conclusion Correct management and appropriate treatment are effective ways for controlling hospital cross infection to the skeptical gas gangrene patients.
引文
1吴在德.外科学.第6版.北京:人民卫生出版社,2003:66.
2Desola J,Escola E,Moreno E,et al.Combined treatment of gaseous gangrene with hyperbaricoxygen therapy,surgey and antibiotics,A national cooperative multicenter study.Med clin,1990,94(17):641-650.
3Ertimann M,Havemann D.Treatment of gasgangrene Results of a retro and prospective analysis of a retro and prospective analysis pf traumarogie patient sample over20years.Unfallchirurg,1992,95(5):471-476.
4Fedorov VD,Borisova OK,Kuleshov SR,et al.Characteristics of wound infection in long-term crush syndrome.Khirurgiia,1990,(6):33-38.
5胡涛.挤压伤并发气性坏疽2例分析.新医药,1976,9(2):1-2.
6白涛.主编.现代创伤诊断学.第1版.广州:人民军医出版社,1996,7.
7石应康.区域性国家级医院在汶川地震医疗救援中的战略支撑作用.中国循证医学杂志,2008,8(6):380-382.
8李大江.汶川地震医疗救援中的伤员接诊处置与转出管理.中国循证医学杂志,2008,8(6):383-385.
9Hospital Infection Control Practices Advisory Committee,1997,2,18
10Takahira N,Shindo M,Tanaka K,et al.Treatment outcome of nonclostridal gasgangrene at level trauma center.J orthop Trmura,2002,16(1):12-17.
2Desola J,Escola E,Moreno E,et al.Combined treatment of gaseous gangrene with hyperbaricoxygen therapy,surgey and antibiotics,A national cooperative multicenter study.Med clin,1990,94(17):641-650.
3Ertimann M,Havemann D.Treatment of gasgangrene Results of a retro and prospective analysis of a retro and prospective analysis pf traumarogie patient sample over20years.Unfallchirurg,1992,95(5):471-476.
4Fedorov VD,Borisova OK,Kuleshov SR,et al.Characteristics of wound infection in long-term crush syndrome.Khirurgiia,1990,(6):33-38.
5胡涛.挤压伤并发气性坏疽2例分析.新医药,1976,9(2):1-2.
6白涛.主编.现代创伤诊断学.第1版.广州:人民军医出版社,1996,7.
7石应康.区域性国家级医院在汶川地震医疗救援中的战略支撑作用.中国循证医学杂志,2008,8(6):380-382.
8李大江.汶川地震医疗救援中的伤员接诊处置与转出管理.中国循证医学杂志,2008,8(6):383-385.
9Hospital Infection Control Practices Advisory Committee,1997,2,18
10Takahira N,Shindo M,Tanaka K,et al.Treatment outcome of nonclostridal gasgangrene at level trauma center.J orthop Trmura,2002,16(1):12-17.
版权所有：© 2023 中国地质图书馆 中国地质调查局地学文献中心