心脏外科患者手术后感染的相关危险因素分析

Study on risk factors for infections in patients after cardiac surgery

目的探讨心脏外科患者手术后感染及其相关感染因素进行分析,以降低感染率。方法随机抽取2009年12月-2011年12月进行心脏及大血管手术患者300例,采用回顾性研究方法,对术后发生感染的患者进行统计分析,对术后发生医院感染的危险因素采用SPSS17.0统计软件进行单因素分析和多因素logistic回归分析。结果 300例患者中有11例发生医院感染,感染率为3.67%;感染患者中年龄>60岁的有9例,占81.82%;感染最常见的部位为呼吸道,7例占63.64%;检出病原菌以革兰阴性菌为主占45.46%,革兰阳性菌占27.27%,真菌占27.27%;经多因素logistic回归分析发现,患者的年龄、手术时间、呼吸机使用时间、导尿管留置时间、术后24h输血浆量等是引起术后感染的独立危险因素。结论心脏外科患者术后感染率较高,且以呼吸道感染最常见,导致患者发生感染的因素较多,临床需要密切注意无菌操作及对感染的及时处理。

OBJECTIVE To study the condition of infections in patients after cardiac surgery and the risk factors so as to reduce the incidence of infections.METHODS Totally 300 patients undergoing major vascular surgery in Dec.2009-Dec.2011 were randomly selected.The retrospective research method was used to conduct statistical analysis on patients with postoperative infections.The SPSS 17.0statistical software was used for the univariate analysis and the multivariate logistic regression analysis of risk factors for postoperative nosocomial infections.RESULTS Totally 11 cases of nosocomial infections occurred in the 300 patients,indicating the infection rate was3.67%.There were nine patients（81.82%）with age over 60 years in the infected patients.The most frequent nosocomial infection site was respiratory tract（seven cases,63.64%）.The pathogens were mainly gram-negative bacteria（45.45%）,followed by gram-positive（27.27%）,and fungi（27.27%）.The multivariate logistic regression analysis revealed that the risk factors for postoperative infections included age,duration of operation,usage duration of ventilator,duration of urinary catheter indwelling,quantity of plasma transfusion in the first 24 hours after operation.CONCLUSION The incidence of postoperative infections is high in patients after cardiac surgery and respiratory tract infection is the most common.As there are many factors causing infections,clinicians should pay close attention to aseptic operation and perform timely treatment to infections.