切口疝补片修补感染的危险因素分析

Risk factors for postoperative infections in patients undergoing incisional hernia synthesis patch repair

目的统计分析胃肠手术腹壁切口疝合成补片修补感染的危险因素,观察相关干预对策的临床效果。方法选取医院2010年4月-2012年8月68例腹壁切口疝合成补片修补术的患者作为对照组,采用常规干预;选择2012年9月-2013年4月66例腹壁切口疝合成补片修补术的患者作为观察组,采用感染干预措施。结果患者感染率对照组为41.2%、观察组为24.2%,两组比较差异有统计学意义(P<0.05);腹壁切口疝合成补片修补术患者术后发生感染的危险因素包括年龄、体质量指数(BMI)、基础疾病、手术方式、手术时间以及切口疝的大小等;其中>50岁、BMI>25kg/m2、有基础疾病、行开放式手术、手术时间>120min、大切口疝及巨大切口疝患者感染率分别为52.6%、60.0%、52.2%、50.0%、59.4%、71.4%及75.0%;患者的术后感染发生率从41.2%下降至24.2%。结论采取有针对性的干预对策严格选择合适的手术方式、控制手术时间、并且做好各种预防措施、及时给予患者相应的抗感染治疗,能有效降低患者手术术后的感染率。

OBJECTIVE To statistically analyze the risk factors for infections in patients undergoing gastrointestinal incisional hernia synthesis patch repair and observe the clinical effects of related interventions .METHODS A total of 68 patients who underwent the incisional hernia synthesis patch repair from Apr 2010 to Aug 2012 were as-signed as the control group and were treated with conventional interventions ;66 patients who underwent the inci-sional hernia synthesis patch repair from Sep 2012 to Apr 2013 were set as the observation group and were treated with interventions to infections .RESULTS The incidence of infeetions was 41 .2% in the control group 24 .2% in the obseroation group ,tlore was stgnicant significant difference betwees the two groups （P〈 0 .05） ;The risk fac-tors for the postoperative infections in the patients undergoing the incisional hernia synthesis patch repair included the age ,body mass index （BMI） ,underlying disease ,surgical approach ,operation duration ,and size of incisional hernia .The incidence rate of postoperative infections was 52 .6% in the patients of more than 50 years of age , 60 .0% in the patients with BMI more than 25 kg/m2 ,52 .2% in the patients with underlying diseases ,50 .0% in the patients undergoing open surgery ,59 .4% in the patients with the operation duration more than 120 min , 71 .4% in the patients with large incisional hernia ,75 .0% in the patients with huge incisional hernia .The incidence rate of the postoperative infections decreased from 41 .2% to 24 .2% .CONCLUSION It is an effective way to tabe tag targeted interventions ,choose appropriate surgical approach ,control the operation duration ,take various precau-tions ,and perform corresponding anti-infection therapies so as to reduce the incidence of postoperative infections .