妇科腹腔镜术后切口感染病原菌调查分析

Distribution of pathogens causing postoperative incision infections in gynecology department patients undergoing laparoscopic surgery

目的探讨妇科腹腔镜术后切口感染的病原菌分布及相关因素,以期为预防感染的发生及感染的后期治疗提供帮助。方法回顾性分析2013年10月-2015年5月于医院妇科1 369例行腹腔镜手术患者临床资料,分析不同术式感染率,并分析感染的病原菌分布及相关因素,数据采用SPSS 20.0软件进行统计分析。结果 1 369例妇科腹腔镜手术患者中63例发生切口感染,发生率为4.60%;共检出57株病原菌,以革兰阴性菌为主,共43株占75.44%;相关因素分析显示,体质量指数≥25kg/m2、手术时间≥60min、术前患者伴有基础疾病、血红蛋白<110g/L、未预防应用抗菌药物是患者腹腔镜术后发生切口感染的相关危险因素(P<0.05)。结论妇科腹腔镜术后切口感染风险高,影响因素较多,为降低术后切口感染率,需积极采取有效的措施。

OBJECTIVE To explore the distribution of pathogens causing postoperative incision infections in gynecology department patients undergoing laparoscopic surgery and analyze the related factors so as to provide guidance for prevention and treatment of the patients.METHODS The clinical data of 1 369 patients who underwent the laparoscopic surgery in the department of gynecology from Oct 2013 to May 2015 were retrospectively analyzed,the infection rates in the patients undergoing different types of surgeries were analyzed,the distribution of pathogens causing the infections and the related factors were observed,and the statistical analysis of data was performed with the use of SPSS 20.0software.RESULTS The incision infections occurred in 63 of 1 369 gynecology department patients undergoing the laparoscopic surgery,with the incidence rate 4.60%.A total of 57 strains of pathogens were isolated,of which 75.44%（43strains）were gram-negative bacteria.The analysis of the related factors showed that the related risk factors for the postoperative incision infections in the patients undergoing the laparoscopic surgery included the body mass index no less than 25kg/m2,operation duration no less than 60 min,preoperative complication with underlying diseases,level of hemoglobin less than 110g/L,and prophylactic use of antibiotics（P〈0.05）.CONCLUSION The gynecology department patients are at high risk of incision infections after the laparoscopic surgery,and there are a variety of influencing factors.It is necessary to take effective measures so as to reduce the incidence of the postoperative incision infections.