剖宫产术后切口感染原因分析及预防措施

Risk factors of incision infections after cesarean section and the preventive measures

目的分析医院产妇剖宫产术后切口感染的相关危险因素,为其预防措施的制定提供理论依据。方法回顾性分析医院2009年1月-2012年10月8976例分娩产妇的临床资料,其中剖宫产术产妇5906例,统计分析剖宫产术后切口感染的发生率及其医院感染的相关危险因素。结果 8976例分娩的产妇中剖宫产术5906例,占65.8%,其中发现术后切口感染49例,感染率为0.8%;剖宫产术后切口感染的发生与产妇的年龄无显著相关性,但剖宫产术后切口感染的产妇体重指数(BMI)、胎膜早破和羊水污染发生率、检查次数、手术时间、术中出血量分别为(28.6±4.2)、40.8%、26.5%、(3.4±1.5)次、(74.6±12.1)min、(213.5±27.4)ml,显著高于非切口感染剖宫产产妇的(24.5±3.7)、12.9%、12.2%、(1.6±0.8)次、(51.7±11.2)min和(156.4±21.3)ml(P<0.05或P<0.01),而剖宫产术后切口感染的产妇的血红蛋白水平为(103.4±11.5)g/L,显著低于非切口感染的剖宫产产妇的(114.8±12.4)g/L,差异有统计学意义(P<0.05)。结论产妇BMI、是否胎膜早破和羊水污染、检查次数、血红蛋白的水平、手术时间、术中出血量是剖宫产术后切口感染的危险因素,做好相关因素的防护有助于减少剖宫产术后切口感染的发生率。

OBJECTIVE To investigate the risk factors of incisional infections in hysterotomy so as to provide theoretical basis for putting forward the preventive measures. METHODS The clinical data of 8976 cases of pregnant women who gave birth in the hospital from Jan 2009 to Oct 2012 were reviewed retrospectively, there were 5906 cases of pregnant women who underwent the hysterotomy. The incidence of the incision infections and the risk factors were statistically analyzed. RESULTS Of totally 8976 cases of pregnant women who gave birth in the hospital, there were 5906 （65.8%） cases who underwent the cesarean section, the incision infections occurred in 49 cases with the infection rate of 0.8%. The incidence of the incisional.infections was not closely related to the age of the pregnant women. The BMI value, incidence of premature rupture of membranes and amniotie fluid contamination, frequency of examination, operation duration, and the blood loss volume of the pregnant women with the incisional infections were respectively （28.64±4.2）, 40.8%, 26.5%, （3.4±1.5） times, （74.6±12.1） min ,and （213.5±27.4） ml, significantly higher than （24. 5±3.7）, 12.9%, 12.2%, （1.6±0. 8） times , （51.7 ±11.2）min ,and（156.4±21.3） ml of the pregnant women without the incisional infections （P〈0.05 or P〈0.01）. However, the Hgb level of the pregnant women with incisional infections was （103.4±11.5） g/L after the cesarean section, significantly lower than （114.8± 12.4） g/L of the pregnant women without the incisional infections, the difference was statistically significant （P〈0. 05）. CONCLUSION The BMI value, incidence of premature rupture of membranes and amniotic fluid contamination, frequency of examination, Hgb level, opera- tion duration, and blood loss volume are the main risk factors of incisional infections after the hysterotomy. The implementation of the corresponding protection measures can contribute to the decrease of incisional infections after hysterotomy.