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2008年汶川地震后颅脑创伤患者头皮伤口感染情况分析

Analysis of scalp wound infections among craniocerebral trauma patients following the 2008 wenchuan earthquake.

作者信息

Liu Jiagang, Ma Lu, You Chao

机构信息

West China Hospital, Sichuan University, Department of Neurosurgery, Chengdu, China.

出版信息

Turk Neurosurg. 2012;22(1):27-31. doi: 10.5137/1019-5149.JTN.4391-11.0.

Abstract

AIM

To explore the causes of scalp wound infection, pathogen distribution, characteristics of antimicrobial susceptibility and therapeutic measures following craniocerebral trauma caused by the 2008 Wenchuan earthquake. MATERIAL and

METHODS

We retrospectively analyzed the microbiology records of patients admitted with craniocerebral trauma to the Department of Neurosurgery, West China Hospital, Sichuan University. Scalp wound infections following craniocerebral trauma were caused by the Wenchuan earthquake.

RESULTS

A total of 82 patients suffered from scalp trauma in this study, including 52.4% cases (43/82) with wound infections, mostly accompanied by severe foreign body contamination, for which the time of first debridement was significantly delayed. There were 59 strains of infectious pathogenic bacteria. Gram-positive bacteria were the most common organisms found (64.4%), including strains of Staphylococcus aureus (26/59, 44.1%) and strains of Staphylococcus epidermidis (12/59, 20.3%). Gram-negative bacteria accounted for 35.6% of samples: 22.0% (13/59) were strains of Enterobacter cloacae; 5.1% (3/59) were strains of Klebsiella pneumoniae; and 8.5% (5/59) were strains of Serratia rubidaea.

CONCLUSION

The rate of scalp wound infections following earthquake-induced craniocerebral trauma, which was dominated by Grampositive Staphylococcus aureus infection, has been markedly elevated in recent years. Early debridement and suturing, nutritional support and application of sensitive antibiotics can augment the therapeutic effect.

摘要

目的

探讨2008年汶川地震所致颅脑创伤后头皮伤口感染的原因、病原菌分布、药敏特点及治疗措施。材料与方法:回顾性分析四川大学华西医院神经外科收治的颅脑创伤患者的微生物学记录。颅脑创伤后的头皮伤口感染由汶川地震所致。结果:本研究共82例患者发生头皮创伤,其中52.4%(43/82)发生伤口感染,多伴有严重异物污染,首次清创时间明显延迟。共分离出59株感染病原菌。革兰阳性菌最为常见(64.4%),包括金黄色葡萄球菌(26/59,44.1%)和表皮葡萄球菌(12/59,20.3%)。革兰阴性菌占样本的35.6%:阴沟肠杆菌占22.0%(13/59);肺炎克雷伯菌占5.1%(3/59);深红沙雷菌占8.5%(5/59)。结论:近年来,地震所致颅脑创伤后头皮伤口感染率明显升高,以革兰阳性菌金黄色葡萄球菌感染为主。早期清创缝合、营养支持及应用敏感抗生素可提高治疗效果。

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