宫腔镜术后盆腔感染的危险因素分析

Risk factors for pelvic infections after hysteroscopic surgery

目的分析宫腔镜术后盆腔感染危险因素,为临床工作提供依据。方法选取2013年6月-2015年6月于医院接受宫腔镜手术100例患者作为研究对象,回顾性分析患者临床资料;记录患者感染类型和病原学检查结果,对其感染的危险因素进行分析。结果 100例宫腔镜手术患者中6例术后发生盆腔感染,感染率为6.00%;共检出病原菌6株,其中链球菌属、葡萄球菌属各1株,大肠埃希菌、肠球菌属各2株;糖尿病患者18例发生感染4例,感染率22.22%;贫血患者16例,感染3例,感染率18.75%;Ⅲ类手术患者39例,发生感染2例,感染率5.13%;Ⅳ类手术19例,感染4例,感染率21.05%;手术>1h患者14例,感染5例,感染率35.71%;有不良生活习惯11例,感染6例,感染率54.55%;患者患有糖尿病、贫血、Ⅲ、Ⅳ类手术类型、手术时间>1h和有不良生活习惯与盆腔感染的发生具有明显的相关性(P<0.05)。结论宫腔镜术后盆腔感染的发生与多因素有关,应加强对高危患者的护理和教育。

OBJECTIVE To investigate the risk factors for pelvic infections after hysteroscopic surgery so as to provide guidance for clinical work.METHODS A total of 100 patients who underwent the hysteroscopic surgery in the hospital from Jun 2013 to Jun 2015 were recruited as the study objects,then the clinical data of the patients were retrospectively analyzed,the types of infections and results of etiological examination were recorded,and the risk factors were observed.RESULTS Of the 100 patients undergoing the hysteroscopic surgery,6had the postoperative infections,with the infection rate 6.00%.Totally 6strains of pathogens were isolated,including 1strain of Streptococcus spp,1strain of Staphylococcus spp,2strains of Escherichia coli,and 2strains of Enterococcus spp.The infections occurred in 4of 18 patients with diabetic mellitus,with the infection rate 22.22%;the infections occurred in 3of 16 patients with anemia,with the infection rate 18.75%;the infections occurred in 2of 39 patients undergoing the typeⅢsurgery,with the infection rate 5.13%;the infections occurred in 4of 19 patients undergoing the typeⅣ surgery,with the infection rate 21.05%;the infections occurred in 5of 14 patients with operation duration more than 1hour,with the infection rate 35.71%;the infections occurred in 6of 11 patients who had bad living habits,with the infection rate 54.55%.The incidence of the pelvic infections was significantly associated with the diabetic mellitus,anemia,typeⅢ,Ⅳ surgery,operation duration more than 1hour,and bad living habits（P〈0.05）.CONCLUSION There are a variety of factors associated with the postoperative pelvic infections in the patients undergoing the hysteroscopic surgery.It is necessary to strengthen the nursing and education of the high-risk patients.