脾切除术后医院感染的临床分析

Nosocomial infection in patients after splenectomy: a clinical analysis

目的探讨脾切除术后医院感染的临床特点及易感因素,以采取有效的防治措施。方法采用回顾性调查方法对338例行脾切除术患者医院感染进行调查分析,应用Logistic回归分析对影响因素进行统计分析。结果脾切除术后患者医院感染发生率为12.1%,感染部位以呼吸道及膈下为主,病原菌以铜绿假单胞菌、大肠埃希菌和金黄色葡萄球菌为主,原发疾病类型、手术时间和术前抗生素的应用情况为危险因素(P<0.05)。结论脾切除术后针对感染因素、感染部位,术前注意改善肝功能及全身情况,术中仔细操作,尽量缩短手术时间;术后加强呼吸道和引流管的管理及合理使用抗生素,可能降低医院感染的发生率。

Objective To investigate the clinical feature and causes of nosocomial infections in patients after splenectomy for developing effective prevention. Methods A retrospective analysis was conducted in 338 patients after splenectomy and logistic regression analyses were performed to analyze related risk factors. Results The rate of nosocomial infection in patients after splenectomy was 12.1%. The main infection sites were respiratory system and subphrenic cavity. The dominant pathogen were Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus. The underlying disease, duration of operation and pre-operational antibiotic therapy were risk factors of nosocomial infection (P<~0.05 ). Conclusions Improving liver function and general conditions before operation, operating carefully and shortening operation duration, effective drainage and antibiotic therapy will help to reduce the rate of nosocomial infection after splenectomy.