胸部手术后手术部位感染的危险因素调查

Survey on Risk Factors of Surgical Site Infection in Post-thoracotomy Surgery

目的分析剖胸术后手术部位感染(SSI)的危险因素。方法分析心胸外科出院病历1 964例,对剖胸术后SSI患者病例进行登记核实。对SSI患者与同期住院未感染者按1:1配比法进行SSI相关因素的调查分析。结果在1 964例出院病历中,发生SSI患者病历89例,感染发生率为4.53%。通过多因素Logistic回归分析结果显示,急诊入院(P=0.019)、手术时间(P=0.000)、术后引流管留置个数(P=0.043)、术后引流管留置时间(P=0.021)、术后预防用药种类(P=0.014)是SSI发生的危险因素。结论通过加强无菌技术操作、缩短手术时间、术后尽早拔除引流管以及合理使用抗生素能有效预防SSI的发生。

Objective To analyze the risk factors of surgical site infection （SSI） in post- thoracotomy incision. Methods A total of 1,964 patients＇ medical records of cardiothoracic surgery were analyzed and the patients with SSI in post - thoracotomy incision were registered and verified. The 1 ： 1 ratio method was applied to select the uninfected patients in the same period, and then the related factors of SSI were surveyed and analyzed. Results There were 89 patients with SSI among 1,964 thoracotomy cases, with the infection rate of 4.53 %. Multiple - variation Logistic regression analysis indicated that the risk factors for SSI were emergency admission （P = 0. 019）, duration of operation （P = 0. 000）, the number of postoperative drainage tubes （P = 0. 043）, duration of postoperative drainage tube （P = 0. 021）, and various kinds of postoperative preventive medica- tion （P = 0. 014）. Conclusions SSI can be effectively prevented by strengthening the sterile operation, shortening the duration of operation, removing the drainage tubes as soon as possible and using antibiotics rationally.