产妇会阴侧切切口感染因素临床分析及预防

Clinical analysis on factors for lateral perineal incision infection in puerperae and prevention

目的探讨引起产妇会阴侧切切口感染的相关影响因素及有效预防措施。方法收集2011年8月-2013年7月妇产科经阴道行会阴侧切分娩的1 968例产妇资料,按照感染与未感染,选择切口感染的101例产妇与同时期行侧切切口未感染的100例产妇进行比较,通过单因素分析,对可能影响切口感染的因素进行分析,数据采用SPSS17.0统计软件进行处理。结果 1 968例经阴道分娩行侧切切口产妇发生切口感染101例,感染率为5.13%;体质量指数(BMI)、平均住院天数、平均住院费用感染组产妇,分别为(27.1±1.3)kg/m2、(13.6±5.7)d、(5 697.78±1 548.62)元,对照组分别为(24.1±1.4)kg/m2、(5.1±1.5)d、(2 896.55±648.97)元,两组比较差异有统计学意义(P<0.05);合并妊娠并发症、生殖道感染多、产程较长、阴道检查次数过多、胎膜早破、阴道助产血肿感染率均明显高于其他影响因素,差异有统计学意义(P<0.05)。结论会阴侧切切口感染的发生率较高,与多种因素相关,因此,应采取有效的护理预防措施消除影响因素,提高产妇的生活质量。

OBJECTIVE To investigate related factors of lateral episiotomy incision infection and effective prevention measures .METHODS Data of 1968 puerperas who delivered by transvaginal episiotomy in the department of gynecology and obstetrics during Aug .2011 to Jul .2013 were collected .And according to the status of infection and non-infection ,101 puerperas with incisional wound infected were compared with 100 puerperas with lateral incisional wound uninfected in the same period . Then by the analysis of single factor , the factors that might influence incisional wound were analyzed .Data were processed by the statistical software SPSS17 .0 .RESULTS There were 101 cases of incisional wound infection in the 1968 puerperas who delivered by transvaginal episiotomy ,the infection rate was 5 .13% .Body mass index （BMI） ,the average length of stay and the average hospitalization costs for puerperas in the infection group were respectively （27 .1 ± 1 .3）kg/m^2 ,（13 .6 ± 5 .7）d , （5697 .78 ± 1548 .62）Yuan ,and for puerperas in the control group were respectively （24 .1 ± 1 .4）kg/m2 ,（5 .1 ± 1 .5）d ,（2896 .55 ± 648 .97）Yuan .The differences between the two groups had significance（P〈0 .05） .The rate of infections due to pregnancy complications , genital tract infection , long stage of labor , frequent vaginal examination ,premature rupture of membranes ,and vaginal delivery hematoma were significantly higher than those due to other influencing factors ,and the differences had significance（P〈0 .05） .CONCLUSION The infection rate of lateral perineal incision is high ,which is related to many factors .Therefore ,clinicians should take effective nursing measures to eliminate the influencing factors to improve the life quality of the maternity .