子宫切除术后阴道感染的危险因素分析及干预对策

Risk factors of vaginal infections after hysterectomy and intervention measures

目的分析子宫切除术围手术期混合性阴道感染的危险因素,制定干预对策,降低感染发生率。方法采用回顾性病例对照的研究方法,对比研究子宫切除术围手术期出现混合性阴道感染的75例患者(感染组)及未出现感染的210例患者(未感染组),危险因素分析采用单因素及多因素非条件logistic回归分析,模型筛选采用Stepwise法。结果单因素分析显示,感染的危险因素包括年龄>50岁、有剖宫产史、合并外伤及基础疾病、急诊手术、阴道检查次数多、未预防性使用头孢菌素等(P<0.05);多因素分析显示,合并外伤及基础疾病、阴道检查次数多、未预防性使用头孢菌素为感染的独立高危因素(OR值均>2)。结论子宫切除术围手术期混合性阴道感染发生与多种因素有关,临床应采取严格无菌措施、预防性使用抗菌药物、减少非必要检查等措施,使感染率得到有效控制。

OBJECTIVE To analyze the risk factors ior mixed hysterectomy and put forward intervention measures so as to means of retrospective case-control study, totally 75 patients vaginal lnlectlons during me perloperauve pcriou u reduce the incidence of the infections. METHODS By with mixed vaginal infections （the infections group） and 210 cases without the mixed vaginal infections during the perioperative period of hysterectomy were enrolled in the study, then the univariate analysis and the unconditional multivariate logistic regression analysis were performed to determine the risk factors, and the model screening was carried out with the use of stepwise method. RESULTS The univariate analysis revealed that the risk factors included the more than 50 years of age, history of cesarean section, complication of trauma or underlying disease , emergency surgery, frequent vaginal examination, and without prophylactic use of cephalosporins （P^0.05） ~ multivariate analysis indicated that the complication of trauma or underlying disease, frequent vaginal examination, and without prophylactic use of cephalosporins were the independent risk factors of the infections （ with OR value more than 2）. CONCLUSION There are many factors associated with the mixed vaginal infections during the perioperative period of hysterectomy~ it is necessary for the hospital to employ strict aseptic measures, perform antibiotics prophylaxis, and reduce the frequency of unnecessary examinations so as to effectively control the infections.