妇科老年患者术后腹腔感染的危险因素分析及干预措施

Risk factors for postoperative abdominal infections in elderly patients of department of gynecology and intervention measures

目的探讨妇科老年患者术后腹腔感染的危险因素及相应干预措施,以降低感染率。方法选取2008年3月-2012年12月收治的老年妇科手术患者197例,分为感染组42例、非感染组155例,对两组临床资料和治疗过程进行回顾性分析,采用SPSS13.0软件对患者发生腹腔感染的概率进行分析。结果 197例患者中发生腹腔感染42例,感染率为21.32%,发生腹腔感染的老年妇科手术患者年龄(72.47±8.64)岁,血红蛋白水平较低、手术时间明显较长,与未发生腹腔感染的患者比较差异有统计学意义(P<0.05);合并糖尿病、术前进行放化疗治疗、术后发生肺部感染者发生腹腔感染者明显较多(P<0.05);经过logistic回归分析,上述因素均是老年妇科手术患者术后发生腹腔感染的独立危险因素(P<0.05)。结论老年妇科手术患者术后发生腹腔感染的危险因素较为复杂,临床工作中应积极预防,在手术之后应提前做好感染的准备工作,进行细菌培养和药敏试验,一旦发生感染可在第一时间合理用药。

OBJECTIVE To explore the risk factors for postoperative abdominal infections in elderly patients of de- partment of gynecology and put forward corresponding intervention measures so as to reduce the incidence of infec- tions. METHODS A total of 197 elderly patients who underwent surgery in the department of gynecology from Mar 2008 to Dec 2012 were enrolled in the study and divided into the infection group with 42 cases and the non-infection group with 155 cases, then the clinical data and the treatment courses were retrospectively analyzed, and the inci- dence of the abdominal infections was analyzed by using SPSS13.0 software. RESULTS Of the 197 patients, the abdominal infection occurred in 42 cases with the infection rate of 21.32%. The incidence of abdominal infections was high in the elderly patients with the age of（72.47±8.64）years old, low level of hemoglobin, or long length of hospital stay, as compared with the patients without abdominal infections, the difference was significant（P〈 0.05）. The incidence of abdominal infections was significantly higher in the patients who were complicated with diabetic mellitus, underwent the preoperative radiochemotherapy, or were complicated with postoperative pulmo- nary infections （P〈0.05）. The logistic regression analysis indicated that the above factors were the independent risk factors for the postoperative abdominal infections（P〈0. 05）. CONCLUSION The risk factors for the postoper- ative abdominal infections in the elderly patients of the department of gynecology are complicated. It is necessary to actively take prevention measures in clinical practice, prepare in advance for the control of infections after sur- gery, and perform the bacterial culture and drug susceptibility testing so as to reasonably use antibiotics.