手术时间对手术切口感染影响的研究

Research on influence of surgical time on surgical incision infections

目的研究不同手术时间与手术切口感染的关系,对比分析不同级别手术间中不同手术时间的手术切口感染率。方法选择2014年1-6月于医院进行腹部手术患者共9 965例,根据患者手术间的不同分为两组,普通手术间为A组4 986例,层流净化手术间为B组4 979例;采用回顾性调查方法,调查患者不同手术时间（〈2、2~4、≥4h）术后30d以内发生的浅表切口、深层切口、器官或腔隙性感染及有植入物滞留体内的手术时间在1年内发生与手术有关的感染;采用SPSS 13.0软件进行统计分析。结果手术时间〈2h患者手术切口感染率A组为0.97%、B组为0.67%,两组手术切口感染率比较差异无统计学意义;手术时间2~4h患者手术切口感染率A组为1.21%、B组为0.64%,手术时间≥4h患者手术切口感染率A组为1.80%、B组为0.87%,两组比较差异均有统计学意义（P〈0.05）。结论随手术时间延长,普通手术间或层流净化手术间,手术切口感染率均呈上升趋势,普通手术间手术患者切口感染率高于层流净化手术间。

OBJECTIVE To study the relationship between different surgical time and surgical incision infections and conduct a comparative analysis of surgical incision infection rates after different surgical time in surgical operating rooms with different cleanliness grades.METHODS A total of 9 965 cases undergoing abdominal surgery in the operating rooms during Jan.-Jul.2014 were enrolled and divided into two groups by operating rooms,i.e.,group A（general operating rooms,n=4 986）and group B（laminar flow depurated rooms,n=4 979）.The retrospective survey was conducted to investigate the infections in superficial incision,deep incision,organs or lacuna at 30 days after surgical time（〈2h,2-4h,≥4h）and infections related to retained implants within one year after the surgery.The software SPSS 13.0 was used for statistical analysis.RESULTS The incision infection rate was0.97%in group A and 0.67%in group B for patients undergoing surgeries shorter than 2h,with no significant difference between the two groups.The incision infection rate was 1.21%in group A and 0.64%in group B for patients undergoing surgeries lasting 2-4h;and the incision infection rate was 1.80%in group A and 0.87%in group B for patients undergoing surgeries longer than 4h,with significant difference between the two groups（P〈0.05）.CONCLUSIONThe surgical incision infection rate is rising along with prolonged surgery time,no matter in general operating rooms or in laminar flow depurated operating rooms.The surgical incision infection rate in general operating rooms is higher than in laminar flow depurated operating rooms.