乳腺外科手术患者切口感染危险因素的调查

Investigation of risk factors of incision infections in breast surgery

目的研讨乳腺外科手术患者切口感染的相关危险因素,降低患者切口感染率。方法选取医院2012年1月-2014年10月实施乳腺外科手术的患者1 332例作为研究对象,对患者的切口感染率和相关危险因素进行统计分析,数据采用SPSS 19.1统计软件进行处理。结果 1 332例患者发生切口感染34例,感染率为2.55%;共检出病原菌28株,其中革兰阴性菌17株占60.71%,革兰阳性菌11株占39.29%;革兰阴性菌对抗菌药物耐药率较低,革兰阳性菌对抗菌药物耐药率较高;乳腺癌手术患者感染率明显高于乳腺象限切除术、乳腺肿物切除术、化疗置入取出术、乳腺肿物穿刺术和乳腺科其他手术患者,差异有统计学意义(P<0.01)。结论导致乳腺外科手术患者切口感染的危险因素主要有手术类型、手术切口类型和手术时间,临床应针对上述危险因素,有针对性的进行预防处理,以降低患者的切口感染率。

OBJECTIVE To investigate the risk factors of incision infection in breast surgery,so as to reduce the incidence of incision infections.METHODS Totally 1332 cases of breast surgery from Jan.2012 to Oct.2014 in the hospital were chosen as the research subjects.The incision infection rate and the related risk factors were statistically analyzed by software SPSS 19.1.RESULTSIn the 1332 cases of patients,34 cases had incision infection,and the incision infection rate was 2.55%.Totally 28 pathogens were detected in the 34 cases of incision infections,including 17 strains of gram-negative bacteria accounting for 60.71%,11 strains of gram-positive bacteria accounting for 39.29%.The resistance of gram-negative bacteria to antimicrobials was low,while gram-positive bacteria were highly resistant to antimicrobial drugs.The infection rate of breast cancer surgery was significantly higher than other types of surgeries such as breast quadrant surgery,breast tumor resection,chemotherapy placement（removal）surgery,breast tumor puncture and other breast surgeries（P〈0.01）.CONCLUSION The risk factors causing incision infections in breast surgery are mainly associated with the types of surgery,types of incision and surgical time.Clinicians should take targeted preventive treatment in the response to the risk factors,so as to reduce the patient＇s incision infection rate.