胃结肠手术部位感染相关危险因素研究

Research on risk factors of surgical site infections of gastrocolic surgery

目的探讨胃结肠手术部位感染(SSI)的危险因素,为SSI的预防控制措施提供依据。方法采用目标性监测的方法,研究胃结肠手术后SSI的发生,采用SPSS 10.0软件对其相关危险因素,如术前住院日、血糖、外周血血浆白蛋白、术前发热、手术持续时间、手术方式、ASA评分、内镜使用、失血量、术后引流管放置天数、入住ICU等25个变量进行单因素和多元logistic回归分析。结果 502例胃结肠手术后SSI发生率为6.17%,其中住院期间感染24例,感染率为77.4%,出院后随访感染7例,感染率为22.6%;多元logistic回归分析显示,血糖异常(P=0.002)、手术持续时间长(P=0.000)、内镜使用(P=0.032)是SSI发生的主要危险因素。结论胃结肠SSI是多因素综合作用引起的,开展目标性监测加强对临床干预可促使医疗质量持续改进,降低SSI发生率。

OBJECTIVE To explore the risk factors of gastrocolic surgical site infection（SSI） and providing basis on preventing and controlling measures on SSI.METHODS The occurrence of SSI was monitored,both single and multiple regression logistic analysis were executed with SPSS on the 25 variables like periods in hospital before surgery,glucose level,blood plasma albumin,fever before surgery,duration of operation,operating mode,ASA rating,endoscopy applying,blood loss and etc.RESULTS Among the sample of 502 gastrocolic surgeries,the occurring rate of SSI was 6.17%,during which 24（77.4%） in hospital,7（22.6%） after discharged from hospital.As the multiple regression analysis indicates： abnormal level of glucose（P=0.002）,excessive time duration of operation（P=0.000）,endoscopy application（P=0.032） constitute the main risk factors of SSI.CONCLUSION Multiple factors are caused by comprehensive effects,occurring rate of gastrocolic SSI can be decreased by targeted monitoring and clinical intervention.