摘要：
Objective To explore the the relationship of bacterial infection, injury mechanism and extent of injury of hand trauma to guide the treatmentthrough the retrospective study.Methods The 239 cases of infection after hand injury from The Hand-Foot surgery of the Affiliated Hospital of Chengde Medical University were collected in 2011-2016.There were 181 males and 58 females, aged 4～77, with an average age of (42.96±12.60).Correlation analysis was performed on the injury mechanism, the injury degree, and the type of bacteria infected.Results From the 239 cases, rolling cutter and avulsion with severe hand injuriesaccounted for 21.8％, crush injury and bruise accounted for23.4％.There were different types of bacteria after different grades, Gram-positive bacteriaaccountedfor 38.3％in Grade I.The Gram-positive and Gram-negative bacteria accounted for 36.7％and 40.8％in GradeⅡ.Infections were mainly Gram-negative bacteria, and accountedfor 65.8％ and 71.9％in GradeⅢ and Ⅳ.There were significant differencesin between grade I～Ⅳ.The pathogenic bacteria Pseudomonas aeruginosa accountedfor 20.6％, and Staphylococcus aureus accounted for 14.7％.The bacteria were mainly Gram-negative.Conclusion The type ofbacterial changes with the severity of the injury.Gram-positive bacteria are the mainly type of patients with gradeⅠtrauma.Gram-negative bacteria were the mainly type of patients with gradeⅢandⅣtrauma.In order to reduce the incidence of infection, the clinicians should choose antibiotics according to different grades of hand injuries.%目的 通过对手外伤术后感染细菌种类与受伤机制、受伤程度的相关性分析,探讨三者之间关系用以指导临床用药.方法 收集承德医学院附属医院手足外科2011-2016年手外伤术后感染病例,其中男181例,女58例,年龄4～77岁,平均年龄 (42.96±12.60) 岁,对受伤机制、受伤程度、感染细菌种类等进行统计学分析.结果239例术后感染病人中,重度和严重的绞轧、撕脱伤占比21.8％,挤压、砸伤占比23.4％;不同分级术后感染细菌种类不同,Ⅰ级革兰氏阳性菌占比38.3％,Ⅱ级革兰氏阳性菌和革兰氏阴性菌分别占比为36.7％和40.8％,Ⅲ级及Ⅳ级以革兰氏阴性菌为主,分别占比为65.8％和71.9％,各级之间感染细菌种类差异有统计学意义;分离致病菌铜绿假单胞菌为20.6％,金黄色葡萄球菌为14.7％,以革兰氏阴性菌为主.结论 手外伤术后感染细菌种类随着损伤程度变化而发生变化;程度较轻的病人以革兰氏阳性菌为主,程度较重的病人以革兰氏阴性菌为主.临床医师应根据不同损伤程度选择合适抗生素,减少感染发生.
