手术切口感染的危险因素分析及干预对策

Risk factors for surgical incision infections in operating rooms and intervention countermeasures

目的分析手术切口感染的手术室危险因素,制定相应的干预对策,以降低感染率。方法回顾性分析2006年6月-2011年12月在医院手术室手术的2699例患者资料,对患者性别、年龄、基础疾病、手术时间、手术部位、手术间安排、急诊/择期、手术次数、术中抗菌药物应用,采用单因素和多因素非条件logistic回归分析,模型筛选采用Stepwise法,评价手术切口感染的手术室危险因素。结果 2699例患者中24例发生感染,感染率为0.89%;年龄、基础疾病、手术时间、手术部位、手术间安排、急诊/择期、手术次数、术中抗菌药物应用等与感染相关;对单因素有意义的因素进行多因素分析,基础疾病、未使用抗菌药物、急诊手术间、急诊手术为危险因素。结论为降低手术切口感染,应提高手术室环境洁净度、手术人员的手的无菌程度、熟练程度、手术质量,合理应用抗菌药物。

OBJECTIVE To analyze the risk factors for surgical incision infections in the operating rooms and put forward corresponding interventions so as to reduce the infection rate.METHODS The clinical data of 2699cases of patients who underwent surgery in the operating rooms from Jun 2006to Dec 2011were retrospectively analyzed,then the univariate non-conditional logistic regression analysis and the multivariate non-conditional logistic regression analysis were performed for gender,age,underlying diseases,operation duration,surgical sites,arrangement of operating rooms,emergency selection,operation frequency,intraoperative use of antibiotics,and wound,the model screening was performed by Stepwise method,finally the risk factors for the surgical incision infections in the operating rooms were evaluated.RESULTS Of totally 2699strains of patients,the infections occurred in 24patients with the infection rate of 0.89%.The analysis showed that the underlying diseases,wound infections（P0.05,OR1.0）,operating rooms,operation types,operation duration,operation frequency,and antibiotics were the factors（P0.05,OR1.0）,and the age,underlying diseases,operation duration,arrangement of operating rooms,selection of emergency operation,frequency of operation,intraoperative use of antibiotics,and wound were related to the infections;while the multivariate analysis indicated that the underlying diseases,wound,without use of antibiotics,emergency operating rooms,and emergency operation were the risk factors.CONCLUSIONIt is necessary to improve the environmental cleanliness of operating rooms,sterility of the operation staff＇s hands,proficiency,and operation quality so as to reduce the incidence of surgical incision infections.