普外科患者手术感染危险因素与预防措施分析

Related risk factors and prevention countermeasures for general surgical incision infections

目的探讨分析普外科手术感染相关高危因素及预防措施,为临床手术后预防控制感染率提供依据。方法回顾性分析普外科2010年2月-2014年2月经手术治疗的患者384例,分析其临床资料,研究其发生切口感染的危险因素及探讨预防措施。结果手术治疗的患者有31例发生感染,感染率为8.1%;共检出31株病原菌,其中革兰阴性菌19例占61.3%、革兰阳性菌9例占29.0%、真菌3例占9.7%;胰腺手术感染率最高为20.0%,其余普外科手术部位感染率多约为3.0%;logistic多因素回归分析得出相关危险因素为年龄≥50岁、体质量指数≥24kg/m2、切口长度≥10cm及手术时间≥2h,其中以手术时间最相关。结论普外科手术切口感染率较高、相关因素复杂,在围手术期应采取有针对性的措施进行目标性监测,有效降低手术切口感染的发生。

OBJECTIVE To explore the related risk factors and prevention countermeasures for general surgical incision infections,and provide basis for prevention of postoperative infections.METHODS Totally 384 patients undergoing surgeries from Feb.2010 to Feb.2014 were retrospectively analyzed and their clinical data were analyzed and investigated for the risk factors for incision infections and prevention measures.RESULTS A total of 31 cases of infections occurred in the surgical patients,the infection rate was 8.1%.Totally 31 strains of pathogens were detected,including gram negative bacteria（19cases,61.3%）,gram positive bacteria（9cases,29.0%）,fungi（3cases,9.7%）.The infection rate for pancreas surgery was the highest up to 20.0%.The general surgical infection rates of other surgical sites were mainly 3.0%.logistic multifactor regression analysis showed related risk factors with P〈0.05 were age≥50years,body mass index≥24kg/m2,length of incision≥10cm and operation time≥2h,while the operation time was the most relevant.CONCLUSION General surgical incision infection rate is high,and the related factors are complex.Targeted measures should be taken during the whole perioperative period to effectively reduce surgical incision infections.