普通外科患者术后手术部位感染的易感因素分析及对策

Predisposing factors of surgical site infections after the general surgery and countermeasures

目的分析医院普外科术后手术部位感染的相关危险因素,探讨其相关的预防措施。方法回顾性分析医院2008年12月-2011年12月行普外科手术的患者临床病例资料540例,统计分析产科医院感染的危险因素。结果 540例行普外科手术的患者中共有68例发生手术部位感染,感染率为12.6%;主要以结、直肠和阑尾部位手术为主,其次为胆囊、乳房和胃等脏器部位的手术,分别占所有手术部位感染的35.3%、20.6%、13.2%、10.3%和7.4%;单因素χ2检验显示年龄>50岁,手术时间>120min,Ⅱ、Ⅲ类手术切口,手术切口长度>10cm,术中输血,恶性病变的患者具有较高的术后感染率(P<0.05)。结论普外科术后手术部位感染以结、直肠和阑尾部位手术为主,其次为胆囊、乳房和胃等脏器部位的手术;年龄、手术时间、切口分类、切口长度、术中输血情况和病变性质是手术部位感染的高危因素。

OBJECTIVE To investigate the risk factors of surgical site infection（SSI） after the general surgery and to explore the prevention countermeasures.METHODS The clinical data of 540 patients who underwent the general surgery in the hospital from Dec 2008 to Dec 2011 were retrospectively analyzed,and the risk factors of the nosocomial infections were statistically analyzed.RESULTS Of totally 540 patients,the SSI occurred in 68 cases with the infection rate of 12.6%.The main infectious sites were the colorectal tract（35.3%） and appendix（20.6%）,followed by the gallbladder（13.2%）,breast（10.3%）,and stomach（7.4%）.The χ2 analysis showed that the SSI was closely related to the age（50 years）,operation duration（120 mins）,type Ⅱ and Ⅲ incision surgery,incision length（10 cm）,intraoperative blood transfusion,and malignant lesions（P0.05）.CONCLUSION The SSI mainly occurs in the colorectal tract and appendix after the general surgery,followed by the gallbladder,breast,and stomach.The age,operation duration,type of incision surgery,incision length,intraoperative blood transfusion,and nature of lesions are the high-risk factors for the SSI.