经腹全子宫切除患者手术部位感染相关因素分析

Related factors for surgical site infections in patients undergoing trans-abdominal hysterectomy

目的探讨经腹全子宫切除(TAH)患者手术部位感染(SSI)的相关危险因素,为临床预防和控制SSI提供参考。方法前瞻性调查2013年1月-2014年12月477例在医院住院行全子宫切除手术的患者临床资料,包括年龄、术前住院天数、手术时间、术中失血量、麻醉评分、术前肠道准备、围手术期抗菌药物使用、SSI发生情况、术后其他感染等,统计SSI的感染率,对发生SSI的危险因素进行logistic回归分析;采用SPSS 19.0软件对数据进行统计分析。结果共调查477例患者,发生SSI 51例,感染率为10.69%;单因素分析显示,影响SSI的因素有年龄、术前白细胞异常、术前血糖高、术前肠道准备、手术持续时间(P<0.05);多因素logistic回归分析显示,年龄和手术时间是SSI的独立危险因素。结论做好手术准备工作,规范手术操作,缩短手术时间,可有效控制SSI的发生。

OBJECTIVE To explore the related risk factors for surgical site infections（SSI）in patients undergoing the trans-abdominal hysterectomy so as to provide guidance for clinical prevention and control of SSI.METHODS A prospective survey was conducted to investigate the clinical data of 477 hospitalized patients who underwent the panhysterectomy from Jan 2013 to Dec 2014,including the age,preoperative hospitalization duration,operation duration,intraoperative blood loss volume,anesthesia score,preoperative bowel preparation,perioperative use of antibiotics,incidence of SSI,and other postoperative infections.The incidence of SSI was taken for statistics,the logistic regression analysis was carried out for the risk factors for the SSI,and the statistical analysis of data was performed with the use of SPSS 19.0software.RESULTS Of 477 patients,51had the SSI with the infection rate of10.69%.The univariate analysis indicated that the influencing factors for the SSI included the age,preoperative abnormal level of leukocytes,preoperative high level of blood glucose,preoperative bowel preparation,and operation duration（P〈0.05）.The multivariate logisticregression analysis indicated that the age and operation duration were the independent risk factors for the SSI.CONCLUSIONIt is an effective way to conduct fully preoperative preparation,standardize the surgical procedures,and shorten the operation duration so as to control the SSI.