初产妇产褥期医院感染的发生与影响因素分析

Analysis of occurrence and influencing factors of puerperal infections in primipara

目的分析初产妇产褥期医院感染的发生及影响因素,为产褥期感染的预防工作提供依据。方法选取2012年1月-2015年1月分娩并出现产褥期感染的130例初产妇作为感染组,随机选取同一时期300例分娩未发生感染的初产妇作为对照组,比较两组初产妇的临床资料,分析其感染部位和病原菌分布,并对产褥期医院感染的影响因素进行分析。结果 130例初产妇会阴部感染率占35.38%、手术切口感染率占19.23%,未发生败血症及脓毒血症等全身性感染;初产妇产褥期共分离出144株病原菌,其中大肠埃希菌检出最多42株,占29.16%;两组初产妇的年龄、孕周、剖宫产率、会阴侧切率和多胎妊娠发生率比较,差异无统计学意义,患者的产钳/胎头吸引助产率、宫内监护率和合并症发生率比较,差异有统计学意义(P<0.05);产钳/胎头吸引、多胎妊娠和合并症与产褥期感染具有明显相关性,差异有统计学意义(P<0.05)。结论初产妇产褥期医院感染与多种因素有关,临床上应加强初产妇的护理和产后保健知识的宣传。

OBJECTIVE To analyze the hospital infections of the primipara during puerperal stage and its influential factors so as to provide support for the prevention of infections .METHODS From Jan .2012 to Jan .2015 ,130 ca‐ses of primipara with puerperal infection were chosen as infection group ,at the same time ,300 cases if primipara were chosen randomly as control group .The clinical data of the two groups were compared .The infection occur‐rence of primipara and its influential factors were analyzed .RESULTS In the 130 cases ,35 .38% of them were in‐fected in perineum and 19 .23% of them appeared surgery incision infections .No case was founded to have sepsis or septicopyemia .Totally 144 strains of pathogens were isolated ,including 42 strains of Escherichia coli ,which dominated the majority and accounted for 29 .16% .The differences of age ,gestational weeks ,rate of cesarean section ,rate of lateral episiotomy and rate of multifetation were not significant .However ,differences of rate of accouche ,rate of intrauterine monitoring and rate of complications were significant（P〈0 .05） .Accouche equip‐ments ,muntifetation and complications were obviously the risk factors for puerperal infections .CONCLUSION The puerperal infections of primipara is related to multiple factors ,and the nursing care and the propaganda of postpar‐tum‐health knowledge should be valued .