剖宫产手术部位感染临床特点分析

Clinical characteristics of surgical site infections after cesarean section

目的探讨剖宫产手术部位感染(SSI)临床特点及预防措施。方法回顾性分析剖宫产2450例产妇的临床资料;观察病原菌分布、SSI发生情况及相关因素、临床结果。结果 2450例剖宫产产妇合并SSI共80例,占3.26%;检出病原菌52株,革兰阴性杆菌40株,革兰阳性球菌12株,SSI组年龄大、检查和治疗次数多、体质量指数高、术前身体状况分级低、试产时间长、瘢痕子宫比例高、手术时间长,是SSI的危险因素,SSI经过治疗均痊愈,住院时间(7.12±2.56)d,长于非SSI组的(5.22±2.13)d,差异有统计学意义(P<0.05)。结论剖宫产术发生SSI发生率较高,虽然愈合良好,但延长住院时间,应采用合理方法预防SSI,做好产前检查保健工作、提高手术水平、合理使用抗菌药物。

OBJECTIVE To explore the clinical characteristics of surgical site infection（SSI） after cesarean section and preventive measures.METHODS The clinical data of 2450 cases receiving cesarean section were retrospectively analyzed;the incidence of SSI,distribution of the pathogens,related factors of SSI,and clinical outcomes were analyzed.RESULTS Totally 80 of 2450 cesarean section cases were complicated with SSI,accounting for 3.26%;52 trains of pathogens were detected,including 40 strains of gram-negative bacilli and 12 strains of gram-positive cocci;the aduanced age,frequent examination and treatment,high body mass index,low ASA before surgery,long trial laboring time,high proportion of uterine scar,and long operation time were the risk factors for SSI.SSI patients were healed after treatment.Hospital stay was（7.12±2.56） days in SSI group,longer than that in non-SSI group（5.22±2.13）days,with statistically significant difference（P0.05）.CONCLUSION Cesarean section is with high incidence of SSI.Although the healing is good,it prolongs hospitalization time.We should adopt reasonable method to prevent SSI,make well-done antenatal examination and healthcare,improve the level of surgery,and reasonably use antibiotics.