腹腔镜辅助阴式全子宫切除术后医院感染分析

Nosocomial infections after laparoscopic assisted vaginal hysterectomy

目的：探讨腹腔镜辅助阴式全子宫切除术（LAVH）后并发盆腔感染的原因及预防治疗措施，从而降低LAVH术后感染的发生。方法选取2009年5月-2012年12月行LAVH的356例患者作为观察组，同时选取2008年1月-2009年4月行LAVH的87例患者作为对照组，观察两组患者手术情况及术后盆腔感染，运用SPSS13．0进行统计分析，计量资料采用t检验，计数资料采用χ2检验。结果观察组中有11例患者发生盆腔感染，感染率为3．10％，对照组有8例患者发生盆腔感染，感染率为9．19％，两组比较差异有统计学意义（P＜0．05）；观察组患者手术时间为（72．6±30．4）min、术中出血量为（186．7±100．3）ml，对照组手术时间为（80．5±34．5）min、术中出血量为（197．8±89．6）ml，两组患者手术时间及术中出血量比较，差异无统计学意义；11例盆腔感染患者在确诊后，改用头孢曲松1．0g每日两次静脉注射，在用药1～3d后体温恢复正常，盆腔感染治愈。结论LAVH具有微创、术后恢复快等优点，但术后易发生盆腔感染，临床上应重视其预防治疗，以降低盆腔感染的发生，促进患者术后恢复。

OBJECTIVE To investigate the causes and preventative measures for LAVH , so as to reduce the occurrence of infections after LAVH .METHODS 356 LAVH patients who were hospitalized during May 2009 to Dec 2012 were selected as the observation group ,and 87 LAVH patients who were hospitalized during Jan 2008 to Apr 2009 were selected as the control group ;operation status and post-operation condition of pelvic infection were observed ,statistical analysis was conducted with SPSS 13 .0 Software ,measurement data were analyzed with t-test and detected enumeration data with Chi-square test .RESULTS There were 11 cases in the observation group suffered from pelvic infections with an infection rate of 3 .10% ,while there were 8 cases in the control group had pelvic infections with an infection rate of 9 .19% ;the difference between them had a statistical significance （P〈0 .05） .The patients in the observation group took （72 .6 ± 30 .4）min for an operation ,and the amount of bleeding lost in operation was （186 .7 ± 100 .3）ml;while the patient in the control group took （80 .5 ± 34 .5）min for operation ,and the amount of bleeding lost in operation was（197 .8 ± 89 .6）ml;the difference between them had no statistical significance . After defined diagnosis , the 11 patients suffered from pelvic infections turned to ceftriaxone sodium ,they took 1 .0 g of it and two-time intravenous injection each day ;after 1-3 days ,their body temperature switched right and the pelvic infection was cured .CONCLUSIONS LAVH have such advantages as minimal invasion and faster postoperative recovery and so on ;since it is prone to suffer from postoperative pelvic infections ,it is necessary to pay more attention to the preventive treatment clinically , so as to reduce the occurrence of pelvic infection and facilitate the postoperative recovery of patients .