心脏起搏术后切口感染危险因素研究

Study of risk factors of infection of incisive wound of postoperative cardiac pacemaker

目的 :探讨心脏起搏术后切口感染的危险因素 ,为控制其感染提供科学依据。方法 :对 2 44例重症缓慢性心律失常患者术后切口感染的 16个危险因素进行调查分析。结果 :发生术后切口感染 46例 ,感染率 18 44 %。单因素分析发现本次住院患者接受手术次数、消毒措施、植入方式、预防用抗生素及易感因素与术后切口感染的发生有显著的联系 ,又经Logistic逐步回归分析筛选出了 5个相互独立的与术后切口感染有显著联系的因素 :年龄、性别、预防用抗生素、术中切口抗生素冲洗和消毒措施 ,其中年龄小于 40岁、男性患者、预防用抗生素种类多是术后切口感染的危险因素。术中切口抗生素冲洗、消毒措施为预防术后切口感染的保护性因素。结论 :心脏起搏术后切口感染给患者增加了不应有的痛苦和经济负担。加强对患者的医护管理 ,特别是具有感染危险因素的患者 ,采取有效的消毒灭菌措施 ,术中严格无菌技术操作及止血 ,实施切口抗生素冲洗 ,术后严密观察切口愈合情况 ,合理应用抗生素并施之精心护理 ,对降低心脏起搏术后切口感染发生率 。

Aim: The risk factors were exploked and to provide the scientific evidence for dominate the infection of incisive wound of postoperative cardiac pacemaker. Methods: Investigate and analyze the 16 risk factors of infection of incisive wound of postoperative, the heart pacemaker of 244 patients of sinus of slow arrhythmia.Results: 46 patients has taken place postoperative infection, infection rate was 18.44%. Single factor analysis showed that the postoperative infection of incisive wound had significant relationship of the operational time, sterile measure, ways of implantation, preventive antibiotic and susceptible factors. Logistic stepwise regression analysis showed 5 independent factors were age, sex, preventive antibiotic, douche of incision with antibiotic during operation and sterile measure, and male, younger than 40 years old, the types of preventive antibiotic were the risk factors of postoperative infection incision. Wash of incision with antibiotic during operation, sterile measures were the protective factors of preventive postoperative infection of incision. Conclusion: If the patients, factor of the heart pacemaker is infective after operative, the patients have the sufferings and economic bear. Medical staff should intense the medical care manage and pay special attention to the patients who have risk factors of infect, take effective disinfect measure, have rigid aseptic wash or stop bleeding during operation, irrigate the incision with antibiotic, watch the incision healing,and give the suitable after operation, these measures can decrease the rate of postoperative infective incision of cardiac pacemaker and have significant sense for increase medical care qualify.