腹部手术后切口感染的原因分析

Causal Analysis of Postoperative Abdominal Incision Infection

目的分析腹腔手术后切口感染的原因,探讨预防切口感染的措施。方法对本科2002年10月—2005年10月收治的1522例普外科腹部手术病例,包括胃大部分切除术、胰十二指肠切除术、肝移植、脾切除术、胃溃疡穿孔修补术、阑尾切除术、剖腹探查术等手术切口感染进行回顾分析。结果腹部手术切口感染的发生与术前营养状况、长期吸烟、早期进食、术后剧烈咳嗽、缝合技术以及电刀使用有密切关系。结论改善切口缝合技术、早期进食、术后避免剧烈咳嗽、关腹前切口清创、缩短手术时间、尽量避免开腹时使用电刀等措施能有效预防切口感染。

Objective To analyze the causes of postoperative abdominal incision infection and discuss its preventive approaches. Methods A total of 1,522 patients, who were performed with general surgical operation including subtotal gastrectomy, pancreati- coduodenectomy, liver transplantation, splenectomy, perforation repair of gastric ulcer, appendectomy and exploratory laparotomy, were retrospectively analyzed on the aspect of incision infection. Results The occurrence of postoperative abdominal incision infection was associated with bad preoperative nutritive status, long-term smoking, too early food - taking, severe cough after operation, bad sutural skill and electrotomy. Conclusion It is recommended that in order to prevent the abdominal incision infection, doctors take measures such as improvement in suturing, early enteral nutrition, avoidance of severe cough after operation, incision debridement before closing abdomen, shortening operation time and abandoning electrotomy.