阑尾炎术后切口感染相关影响因素及防治措施

Related factors for incision infections after appendicitis surgery and the prevention countermeasures

目的研究影响阑尾炎术后切口感染的诸多因素,讨论临床上应对感染的防治措施,为防治阑尾炎术后感染奠定临床基础。方法随机选取2009年7月-2012年2月在医院进行检查且进行急性阑尾炎手术的患者共350例,其中发生切口感染的患者设为研究组,共50例,其余的300例未感染患者设为对照组,比较两组患者在手术过程中可能造成切口感染的因素,并根据其影响因素的结果制定临床的防治措施。结果研究组的体重指数(BMI)为25.1±1.8,对照组患者BMI为23.2±1.9,两组比较差异有统计学意义(P<0.05);研究组病程≥24h的患者占76.0%,明显高于对照组的54.7%;研究组手术时间<1h的患者占72.0%明显高于对照组的57.7%;研究组未进行切口保护的患者占84.0%,明显高于对照组的47.7%;研究组切除方法为逆行者占4.0%,明显高于对照组的53.0%,研究组引流出口为原切口者占72.0%,明显高于对照组的58.0%;研究组病理类型为化脓性占70.0%,单纯性占6.0%,坏疽穿孔性占24.0%与对照组的51.0%、16.7%和32.3%比较差异有统计学意义(P<0.05)。结论导致阑尾炎术后切口感染因素众多,临床应进行积极有效地防治,减轻患者痛苦。

OBJECTIVE To study the related factors for incision infections after the appendicitis surgery and to explore the clinical prevention measures so as to lay foundation for the prevention of infections after the appendicitis surgery. METHODS A total of 350 patients who were examined in the hospital and underwent the acute appendicitis surgery from Jul 2009 to Feb 2012 were randomly selected as the study objects, among which the patients with incision infections were assigned as the study group （n= 50 cases）, and the patients without infections were assigned as the control group （n= 300 cases）. The related risk factors for the intraoperative incision infections between the two groups were compared, and the clinical prevention measures were formulated in response to the risk factors. RESULTS The body mass index （BMI） is 25.1±1.8 in the study group, 23.2±1.9 in the control group, the difference was statistically significant （P〈0.05）. The patients of the study group with the disease course more than 24 hours accounted for 76. 0%, significantly higher than 54. 7% of the control group; the patients of the study group with the operation duration less than 1 hour accounted for 72.0%, significantly higher than 57.7% of the control group; the patients of the study group without incision protection accounted for 84.0%, significantly higher than 47.7% of the control group; the patients of the study group who underwent the retrograde resection accounted for 74.0%, significantly higher than 53.0% of the control group; the patients in the study group with the drainage export as the original incision accounted for 72.0 %, significantly higher than 58. 0% of the control group. Of all the pathological types of the study group, the patients with purulent type accounted for 70. 0%, the patients with simple type 6. 0%, the patients with gangrene and perforation type, respectively higher than 51.0%, 16.7%, and 32.3% of the control group, the difference was statistically significant （P〈0.05） . CONCLUSION There are a variety of factors associated with the incision infections after the appendicitis surgery, the effective prevention measures should be taken to alleviate the patients＇ suffering.