外科手术患者感染的相关因素分析及对策

Risk factors and countermeasures for surgical incision infections

目的探讨外科手术患者发生术后感染的相关因素,并对于相关预防对策进行分析。方法回顾性分析2009年9月-2012年3月612例外科手术患者临床资料,通过单因素和多因素分析对危险因素进行评价,纳入因素包括患者性别、年龄、是否为肿瘤、切口分类、手术时间、失血量、聚维酮碘切口消毒与抗菌药物的使用。结果单因素分析得出手术时间>6h、年龄<8岁与>60岁、术中使用抗菌药物类型、手术出血量≥800ml、未用聚维酮碘消毒切口、患者肿瘤及切口分类等是术后感染相关因素,多因素logistic回归分析筛选出发生术后感染的独立危险因素为年龄(OR>1.633)、切口分类(OR>1.255)、术中出血量(OR>0.884)、手术时间(OR>0.962)及是否用聚维酮碘清洗伤口(OR>1.569)。结论外科手术后感染因素多,手术过程中的侵入性感染和手术者的无菌操作意识不强等均是外科手术后感染的主要因素。

OBJECTIVE To explore the related factors leading to surgical incision infections so as to put forward the effective countermeasures.METHODS From Sep 2009to Mar 2012,the clinical data of 612cases of patients who underwent surgery were retrospectively analyzed,the univariate analysis and the multivariate analysis were performed to evaluate the risk factors,including the gender,age,tumor,incision types,operation duration,blood loss volume,iodine for incision disinfection,and use of antibiotics.RESULTS The univariate analysis showed that the operation duration,age,types of antibiotics used,blood loss volume,iodine for incision disinfection,tumor,and incision classification were the risk factors for the postoperative infections,while the multivariate logistic regression analysis indicated that the age（OR1.633）,classification of incision（OR1.255）,blood loss volume（OR0.884）,operation duration（OR0.962）,and wound rinsing with povidone-iodine wound（OR1.569） were the independent risk factors for the postoperative infections.CONCLUSIONThere are a lot of factors leading to the surgical incision infections,and the invasive infections and the poor awareness of aseptic operation are the main risk factors for the postoperative surgical incision infections.