肝胆外科手术切口感染相关危险因素分析

Related risk factors for incision infections in department of hepatobiliary surgery

目的分析肝胆外科手术切口感染的相关因素,为临床防治提供依据。方法回顾性分析医院2008年2月-2012年2月收治的685例肝胆外科手术患者临床资料,采用统一调查表登记,以切口感染为因变量,以患者临床资料为自变量,单因素分析其与切口感染的关系,并对有统计学意义的危险因素进行logistic回归分析。结果 685例肝胆手术开腹患者,发生术后感染132例,占19.3%;对其中13项与手术切口感染危险因素进行统计,其中总胆红素、白细胞、血红蛋白水平、手术时间、术中失血量、术中抗菌药物种类、手术切口分类及聚维酮碘冲洗切口与否和手术分组均对手术切口感染有影响,对引起手术切口感染的9项危险因素进行logistic回归分析,结果显示,手术切口分类、手术分组、聚维酮碘冲洗切口、手术时间及术中出血量与手术切口感染的关系较密切。结论在进行肝胆外科手术过程中,严格掌握手术适应证,对易发危险因素进行积极防治是减少手术切口感染的主要措施。

OBJECTIVE To analyze the related factors for the incision infections in the department of hepatobiliary surgery so as to provide basis for the clinical prevention.METHODS The clinical data of 685 patients who underwent the hepatobiliary surgery from Feb 2008 to Feb 2012 were retrospectively analyzed.By means of the unified questionnaire registration,with incision infection as the dependent variable,and the clinical data of the patients as independent variables,the univariate analysis was performed for its correlation with the incision infections,and the logistic regression analysis was performed for the risk factors with statistical significance.RESULTS Of 685 patients undergoing the hepatobiliary surgery,there were 132（19.3%） patients with the postoperative infections.Of 13 risk factors involved in the statistical analysis,the total bilirubin level,white blood cell count,hemoglobin level,operation duration,intraoperative blood loss,type of antibiotics used during the surgery,classification of surgical incision,incision rinse with iodophors,and the type of surgery could influence the surgical incision infections.The logistic regression analysis of 9 risk factors for the surgical incision infections indicated that the surgical incision infections was closely related to the type of surgical incision,type of surgery,incision rinse with povidone iodine,operation duration,and intraoperative blood loss.CONCLUSION It is necessary to understand the indications for the hepatobiliary surgery,and it is an effective way to reduce the incidence of surgical incision infections by actively preventing the predisposing factors.