剖宫产手术切口感染目标性监测资料分析

Analysis on targeted surveillance data of incision infection during cesarean section

目的:探讨剖宫产手术切口感染的危险因素和病原菌。方法:采用目标性监测的方法,收集剖宫产手术切口感染危险因素和病原学资料,并对资料进行单因素分析与Binary Logistic回归分析。结果:2510例剖宫产中有53例发生切口感染,感染率为2.11%。对资料进行单因素分析发现NNIS、皮下组织最大厚度、术中出血量、低蛋白血症、中/重度贫血、糖尿病、妊娠高血压、阴检次数、宫口开大程度、胎膜早破、羊膜腔感染等因素可能与剖宫产切口感染有关。对资料进行Logistic回归确定NNIS(OR=1.672)、羊膜腔感染(OR=2.141)、术中出血量(OR=1.721)、糖尿病(OR=2.515)、皮下组织最大厚度(OR=1.305)、宫口开大程度(OR=1.158)等因素为剖宫产手术切口感染的独立危险因素。在切口感染的病原菌中,G-杆菌占51.85%(14/27),G+球菌占25.93%(7/27),真菌和厌氧菌各占11.11%(3/27)。结论:对高危人群应采取更严格的预防控制措施以降低剖宫产手术切口感染率。

Objective：To explore the risk factors and pathogens of incision infection during cesarean section.Methods：The risk factors and pathogenic data of incision infection during cesarean section were collected by targeted surveillance method,then the data were analyzed by univariate analysis and Binary logistic regression analysis.Results：Among 2 510 cases undergoing cesarean section,incision infection occurred in 53 cases （2.11%）;univariate analysis indicated that NNIS,maximum thickness of subcutaneous tissues,blood loss during cesarean section,hypoproteinemia,moderate/severe anemia,diabetes,gestational hypertension,frequency of vaginal examination,dilatation of cervix,premature rupture of membrane,infection of amniotic cavity were related to incision infection during cesarean section;logistic regression analysis showed that NNIS （OR=1.672）,infection of amniotic cavity （OR=2.141）,blood loss during cesarean section （OR=1.672）,diabetes （OR=2.515）,maximum thickness of subcutaneous tissues （OR=1.305） and dilatation of cervix （OR=1.158） were independent risk factors of incision infection during cesarean section;among the pathogens inducing incision infection,the proportions of Gram-negative bacilli,Gram-positive coccus,fungi and anaerobes were 51.85% （14/27）,25.93% （7/27）,11.11% （3/27） and 11.11% （3/27）,respectively.Conclusion：Strict preventive and control measures should be adopted to reduce the incision infection rate during cesarean section among high-risk population.