神经外科患者Ⅰ类切口手术部位感染危险因素分析

Risk factors for typeⅠincision surgical site infections in neurosurgery department

目的探讨神经外科Ⅰ类切口手术部位感染的相关危险因素,为临床控制手术部位感染提供依据。方法前瞻性调查2012年10月-2013年10月神经外科1 811例Ⅰ类切口手术患者临床资料,采用SPSS17.0进行统计分析。结果共有102例发生手术部位感染,感染率为5.63%;单因素分析结果显示,术中及术后输血、术中出血量、是否有植入物、是否置引流管、性别、手术时长、是否急诊、NNIS评分、原发疾病与手术部位感染的发生存在密切的相关性,两组差异有统计学意义(P<0.05);多因素分析结果显示,术中出血量大、急诊、有植入物及NNIS评分高是神经外科Ⅰ类切口手术部位感染发生的独立危险因素(P<0.05)。结论在临床工作中,尽可能的降低患者术中出血量并且控制植入物放置及加强急诊和NNIS评分差的患者防护等,以降低感染的发生。

OBJECTIVE To explore the risk factors associated with the type Ⅰ incision surgical site infections in the neurosurgery department so as to provide references for the control of surgical site infections in neurosurgery department .METHODS A prospective survey method was adopted to investigate the type Ⅰincision surgical site infections of 1811 cases of patients in the Neurosurgery Department from Oct .2012 to Oct .2013 ,and the single factor analysis and the multivariate regression analysis were performed .RESULTS The surgical site infections occurred in 102 cases with the incidence rate of 5 .63% .The single factor analysis showed that intraoperative and postoperative transfusion ,intraoperative blood loss ,implants ,drainage tube ,sex ,the operation duration ,NNIS , emergency ,primary disease were closely related to the incidence of the surgical site infections in neurosurgery department ,and the difference between the two groups was significant （P〈0 .05） .The multivariate regression a‐nalysis showed that emergency ,implants ,intraoperative blood loss and NNIS were the independent risk factors for the surgical site infections （P〈0 .05） .CONCLUSION In clinical work ,it is necessary to reduce the intraoperative blood loss ,control the application of implants and intensify the prevention and care of emergency ,male and low‐NNIS patients so as to reduce the incidence of the infections .