創傷后血糖水平對急性傷口感染的影響分析_West China Medical Journal

Authors：

 呂娟 ¹ , 陳佳麗 ² , 李佩芳 ³ ,  寧寧 ²

1. ;
2. ;
3. ;

Corresponding?author：

寧寧, Email: gkningning@126.com

Keywords：

血糖水平; 創傷; 傷口感染

DOI：

10.7507/1002-0179.20150525

Video：

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目的了解創傷后血糖水平對于急性傷口感染的影響。方法采用橫斷面調查研究，通過方便抽樣的方法選擇2012年7月-10月入住骨科的患者進行調查分析。納入標準為年齡≥ 18周歲，住院時間≥ 3 d，入院時已有急性傷口存在或入院后進行手術治療的患者。共576例患者納入研究。結果 576例患者中73例發生傷口感染，發生率為12.7%，其中19例患者的傷口感染屬于手術切口感染，發生率為3.3%。研究對象受傷后首次測量的血糖值為3.24～22.30 mmol/L，中位血糖值5.68 mmol/L。傷口發生感染的患者中位血糖值為6.36 mmol/L，而傷口未感染者中位血糖值為5.67 mmol/L，差異有統計學意義（P＜0.001），多因素分析顯示血糖水平是傷口感染的獨立危險因素（OR=1.592， P＜0.001）。結論創傷后高血糖水平是導致傷口感染的危險因素。

Citation： 呂娟, 陳佳麗, 李佩芳, 寧寧. 創傷后血糖水平對急性傷口感染的影響分析. West China Medical Journal, 2015, 30(10): 1826-1828. doi: 10.7507/1002-0179.20150525 Copy

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1. Singh A, Halder S, Menon GR, et al. Meta-analysis of randomized controlled trials on hydrocolloid occlusive dressing versus conventional gauze dressing in the healing of chronic wounds[J]. Asian J Surg, 2004, 27(1):326-332.
2. Jones J. Examining the multifactorial nature of wound infection[J]. Wound Essentials, 2012, 2(1):90-97.
3. Laird AM, Miller PR, Kilgo PD, et al. Relationship of early hyperglycemia in trauma patients[J]. J Trauma, 2004, 56(5): 1058-1062.
4. Meyfroidt G, Ingels C, Van Den Berghe G. Glycemic control in the ICU[J]. N Engl J Med, 2011, 364(13):1280.
5. Jeremitsky E, Omert L, Dunham CM, et al. Harbingers of poor outcome the day afer severe brain injury:hypothermia, hypoxia, and hypoperfusion[J]. J Trauma, 2003, 54(2):312-319.
6. Kim BO, Kim SW, Lee SM, et al. Relationship of glucose control and wound infection in diabetics after lumbar spine surgery[J]. J Korean Neurosurg Soc, 2005, 37(1):44-47.
7. Lee JH, Kim JJ, Kim YH, et al. Increased risk of peristomal wound infection after percutaneous endoscopic gastrostomy in patients with diabetes mellitus[J]. Dig Liver Dis, 2002, 34(1):857-861.
8. Jeong Y, Mun SP, Chang JH, et al. The risk factors associated with surgical site infection after an abdominal operation[J]. J Korean Surg Soc, 2008, 75(1):177-183.
9. Park JM, Jin SH, Lee SR, et al. Complications with laparoscopically assisted gastrectomy:multivariate analysis of 300 consecutive cases[J]. Surg Endosc, 2008, 22(10):2133-2139.
10. Scalea TM, Bochicchio GV, Bochicchio KM, et al. Tight glycemic control in critically injured trauma patients[J]. Ann Surg, 2007, 246(4):605-612.
11. James E. Blood glucose control in the trauma patient[J]. J Diabetes Sci Technol, 2009, 3(6):1373-1376.

West China Medical Journal

創傷后血糖水平對急性傷口感染的影響分析

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