影响剖宫产术后并发产褥感染的相关危险因素分析

Analysis of Related Risks for Puerperal Infection after Cesarean Section

目的:探讨剖宫产术后产褥感染的相关危险因素,为临床制定感控措施提供参考。方法:回顾性分析我院接受剖宫产术的1760例孕妇的临床资料,采用单因素卡方检验及多因素Logistic回归方法对剖宫产术后发生产褥感染的相关危险因素进行统计学分析。结果:1760例接受剖宫产手术的孕妇,术后发生产褥感染的有68例,发生率为3.86%;发生产褥感染最常见的部位是急性子宫内膜炎、子宫肌炎,其构成比占57.4%;经过单因素卡方检验及多因素Logistic回归分析,最终筛选出手术时间(OR=1.351)、血红蛋白(OR=1.759)、胎膜早破(OR=2.247)、孕期生殖道感染反复发作(OR=2.047)、妊娠糖尿病(OR=1.473)、前置胎盘反复阴道出血(OR=1.584)与宫产术后发生产褥感染呈正相关(P<0.05)。结论:手术时间、血红蛋白、胎膜早破、孕期生殖道感染反复发作、妊娠糖尿病、前置胎盘反复阴道出血是剖宫产后发生产褥感染的高危因素,临床应针对这些高危因素制定干预措施以降低感染的发生率。

Objective： To study the related risk factors for puerperal infection after cesarean section, and provide references for control measures of clinical infection. Methods： A retrospective analysis of 1760 pregnant women who underwent cesarean section in our hospital from February 2008 to February 2014 was performed. The related risk factors for puerperal infection were analyzed by single factor chi-square test and multi-factor Logistic regression method. Results： Among the 1760 cases of pregnant women who underwent cesarean section, 68 cases had puerperal infection after cesarean section, with an incidence of 3.86%. Acute endometritis and uterus myositis were most common in puerperal infection, with a constituent ratio of 57.4%. Single factor chi-square test and multi-factor Logistic regression analysis finally showed that operation time（OR=1.351）, hemoglobin（OR=1.759）, premature rupture of membranes（OR=2.247）,recurrent genital tract infection during pregnancy（OR=2.047）, gestational diabetes mellitus（OR=1.473）, repeated placenta previa vaginal bleeding（OR=1.584） were positively correlated with postoperative（P〈0.05）. Conclusion： Operation time, hemoglobin, premature rupture of membranes, recurrent genital tract infection during pregnancy, gestational diabetes, repeated placenta previa vaginal bleeding were high risks for puerperal infection after cesarean section. Intervention measures should be made to deal with the high risks in order to reduce the incidence of infection.