外阴癌患者术后切口感染的相关因素分析

Risk factors of incision infections after vulvar cancer surgery

目的分析外阴癌患者术后切口感染的相关因素及干预措施,以降低切口感染率。方法回顾性分析医院2010年7月-2013年2月收治的102例外阴癌患者临床资料,将其中42例感染患者作为感染组,其余60例患者为非感染组,对影响切口感染的相关因素进行分析,应用SPSS17.0统计软件,计数资料比较采用χ2检验,均数比较采用t检验,多因素logistic回归分析评估外阴癌患者术后切口感染的独立危险因素。结果 102例外阴癌患者有42例患者发生切口感染,感染率为41.18%;42例感染患者共检出病原菌48株,以革兰阴性菌为主32株占66.66%,革兰阳性菌14株占29.17%,真菌2株占4.17%;单因素分析显示,缝合方式、术后排尿排便、合并其他疾病、阴道检查次数多、阴道炎、术前宣教与外阴癌患者术后切口感染相关,差异有统计学意义(P<0.05);经logistic多因素分析显示,基础疾病、缝合技术、阴道炎、术后排尿便是术后切口感染的独立危险因素。结论加强护理预防,做好围手术期护理,从各个环节评估并识别危险因素,积极采取措施,能有效降低外阴癌患者术后切口感染率,对提高手术质量及患者预后具有重要意义。

OBJECTIVE To explore the relevant factors and intervening measure for the incision infections after vulvar cancer surgery and to reduce the incision infection rate .METHODS A total of 102 cases of patients with vulvar cancer in the people′s hospital of Liaocheng were retrospectively analyzed from Jul .2010 to Feb .2013 ,and were divided into infection group （42 cases） and uninfection group （60 cases） ,the related factors affected the infections of incision were analyzed .The SPSS17 .0 statistical software was used ,the count data were compared with χ2 test ,and the means were compared using t test ,and independent risk factors for wound infection of vulvar cancer patients multivariate were evaluated by logistic regression analysis .RESULTS Among 102 cases of vulvar cancer ,42 cases developed incision infections ,with the infection rate of 41 .18% .Among 42 cases of patients ,48 strains were detected ,most of the pathogens were gram-negative bacteria（32 strains ,66 .66% ） ,and gram positive bacteria were 14 strains（29 .17% ） ,and the fungi were 2 strains （4 .17% ） .The univariate analysis showed that the technique of suture ,urinate and defecate after preoperative ,combined diseases ,vaginal inspections ,vaginitis , preoperative education were the risk factors for the incision infection , and the difference was significant （P〈0 .05） . The multivariate logistics regression analysis revealed that basic diseases , technique of suture , vaginitis ,urinate and defecate after preoperative ,were the independent risk factors for the incision infections after the cesarean section . CONCLUSIONS It is necessary to perform the nursing interventions and perioperative nursing ,to assess and identify risk factors , actively take measures so as to reduce the incidence of incision infections after the vulvar cancer surgery ,which have important guiding significance to improve the operation quality and patient prognosis .