心脏手术患者切口感染与手术室相关因素分析

Operating room-related factors for incision infections in patients undergoing cardiac surgery

目的研究心脏手术患者切口感染手术室环节因素分析与控制对策,为制定预防措施提供依据。方法回顾性调查分析2013年8月-2014年8月129例心脏手术患者切口感染危险因素,探讨手术室环节因素与护理对策。结果心脏手术切口感染发生率为37.98%,不同手术类型切口感染发生率不同;单因素分析显示,患者年龄>65岁、有中重度贫血、切口长度>10cm、手术时间>5h、术中出血>1 500ml、手术部位未保暖、术前住院时间>7d、围术期抗菌药物使用不合理、有参观人员、患有高血压及糖尿病和有内置物与手术切口感染发生有关;多因素logistic回归分析表明,年龄>65岁、术前住院时间>7d、围术期抗菌药物不合理使用是心脏手术切口感染危险因素。结论根据心脏手术切口感染手术室环节因素,制定相应的预防和控制措施,减少手术切口感染的发生。

OBJECTIVE To explore the operating room‐related factors for incision infections in patients undergoing cardiac surgery and put forward control countermeasures so as to provide guidance for the prevention of incision in‐fections .METHODS A total of 129 patients who underwent the cardiac surgery from Aug 2013 to Aug 2014 were enrolled in the study ,the risk factors for infections were retrospectively investigated ,the operating room‐related factors and the nursing countermeasures were explored .RESULTS The incidence of the cardiac surgical incision infections was 37 .98% ,the incidence of the incision infections varied in the patients undergoing different types of surgeries .The univariate analysis indicated that the more than 65 years of age ,moderate to severe anemia ,length of incision more than 10 cm ,operation duration more than 5 hours ,intraoperative hemorrhage volume more than 1500ml ,preoperative warming of surgical sites ,preoperative hospitalization duration more than 7 days ,unreason‐able perioperative use of antibiotics ,visiting personnel ,complication with hypertension and diabetes ,and implants were associated with the incidence of the surgical incision infections .The multivariate logistic regression analysis demonstrated that the more than 65 years of age ,preoperative hospitalization duration more than 7 days ,and un‐reasonable perioperative use of antibiotics were the risk factors for the incision infections in the patients undergoing cardiac surgery .CONCLUSION It is necessary to formulate corresponding prevention and control measures on the basis of the operating room‐related factors so as to reduce the incidence of the surgical incision infections .