妇产科患者术后切口感染影响因素分析

Analysis of influencing factors of incision infection in gynecological and obstetric patients

目的分析妇产科患者术后切口感染的影响因素,提出预防感染的对策,减少患者术后切口感染的发生。方法选择2011年2月-2013年2月妇产科240例实施腹部手术患者,记录发生术后腹部切口感染的患者其体质量、年龄、血红蛋白、手术时间、切口大小、ASA分级、手术部位、用药情况,从用药、手术、患者自身3个方面对妇产科手术腹部切口感染的危险因素进行分析,采用单因素分析方法对影响腹部切口感染的因素进行分析,同时利用多因素logistic回归分析对各可疑影响因素进行分析。结果手术时手术时间、手术种类、术中出血量、切口大小等因素是腹部切口感染的影响因素(P<0.05);用药因素中是否使用抗菌药物对切口进行冲洗、是否预防性应用抗菌药物以及围手术期的用药是腹部切口感染的影响因素(P<0.05);患者自身年龄、体质量、ASA分级、血红蛋白数、个人护理是腹部切口感染的影响因素;logistic回归分析结果显示,上述危险因素是腹部切口感染的独立影响因素。结论从患者自身、围手术期用药和手术3个方面进行干预,对减少切口感染的发生,提高患者生存质量,减少医患纠纷具有重要意义。

OBJECTIVE To analyze the influencing factors of postoperative incision infection in obstetrics and gyne‐cology ,and propose measures to prevent infection and reduce the incidence of postoperative incision infection . METHODS Totally 240 patients who received abdominal surgery in the department of obstetrics and gynecology during Feb .2011 to Feb .2013 were included .Body mass ,age ,hemoglobin ,operative time ,incision size ,ASA grade ,surgical site ,and drug use after the surgery were recorded for patients ,and risk factors for surgical ab‐dominal incision infection were analyzed from three aspects of medication ,surgery ,and patient profile .The univa‐riate analysis was used for influencing factors for abdominal incision infection ,while the multivariate logistic re‐gression analysis was used for each suspicious factor .RESULTS From the surgery aspect ,the operative time , types of surgery ,blood loss ,abdominal incision size and other factors were influencing factors for incision infec‐tion （P〈0 .05） .From the medication aspect ,the use of antibiotics for incision washing ,the prophylactic use of antibiotics and perioperative medication were influencing factors for abdominal incision infection （P〈0 .05） .Pa‐tient′s own age ,body mass ,ASA grade ,hemoglobin count ,personal care were influencing factors for abdominal incision infection .The logistic regression analysis showed that these risk factors could be seen as the independent influencing factors for abdominal incision infection .CONCLUSION Intervention from three aspects of patient pro‐file ,perioperative medication and surgery is important for reducing the incidence of incision infection ,improving patient quality of life ,and reducing medical disputes .