腹腔镜胆囊切除术后切口感染的调查

Investigation of superficial incision infection after laparoscopic cholecystectomy

目的研究腹腔镜胆囊切除术后切口感染的特点,探讨切口感染的预防方法与控制措施。方法选取2014年1月-2015年1月在医院接受腹腔镜胆囊切除术的180例患者作为研究对象,分析其切口感染的相关因素,采用SPSS16.0软件对数据进行统计分析。结果 180例患者发生切口感染21例,切口感染率11.67%;未发生切口感染的患者切口愈合时间为(13.56±3.08)d,发生切口感染的患者切口愈合时间为(8.56±1.12)周,发生与未发生切口感染患者比较,差异有统计学意义(P<0.01);不同性别、年龄患者切口感染率比较,差异无统计学意义;手术时机、患者是否发生胆囊破裂和手术时间,均能影响腹腔镜胆囊切除术后切口感染;发生切口感染的21例患者中,4例由于医源性因素导致感染,5例由于手术操作不规范导致感染,6例由于病情严重导致感染,分别占19.05%、23.80%、28.57%。结论在行腹腔镜胆囊切除术之前,医师应合理评估患者的病情,熟练操作手术,术后重视切口的感染,加强护理,降低感染率。

OBJECTIVE To study the characteristics of superficial incision infection after laparoscopic cholecystectomy,and to discuss prevention and control measures for superficial wound infection.METHODS A total of 180 cases of patients who underwent laparoscopic cholecystectomy in the hospital were selected as study objects from Jan.2014 to Jan.2015.Related factors of wound infection were analyzed.The results were statistically analyzed by software SPSS16.0.RESULTS Among the 180 cases of patients,21 of them were inflicted with incision infection with an infection rate of 11.67%.The average time of patients without incision infection during wound healing was（13.56 ±3.08）days;while for patients with wound infection,the average time was（8.56±1.12）weeks,and the difference was significant（P〈0.01）.Comparing sex and age between the two groups,the differences had no significance.Surgical timing,whether gallbladder rupture or not and the operation time,all had effects on superficial incision infection after laparoscopic cholecystectomy.Among the 21 patients with wound infection,4cases were due to iatrogenic factors,5cases was due to nonstandard surgery operations;6cases were due to serious disease condition,and the infection rates of them were respectively 19.05%,23.80%and 28.57%.CONCLUSION Before laparoscopic cholecystectomy,doctors should carry out a reasonable assessment for the patient＇s condition,make sure proficient surgery,pay attention to postoperative infection,and give intensive care for infection,in order to reduce the incidence of infection.