会阴侧切分娩产妇感染的危险因素分析及干预措施

Risk factors and intervention measures of infections in puerpera of episiotomy delivery

目的探讨会阴侧切分娩产妇感染的危险因素,为会阴侧切分娩产妇感染的干预措施和治疗提供理论依据。方法选择2014年1月-2016年1月在医院行会阴侧切分娩的产妇321例作为研究对象,统计其感染病原菌种类及构成,分析产妇发生感染的单因素及多因素,应用SPSS18.0软件对数据进行统计分析。结果 321例行会阴侧切分娩的产妇中16例发生感染,感染率4.99%;感染产妇中分离出病原菌18株,主要为革兰阳性菌、革兰阴性菌和真菌3大类,其构成比分别为33.34%、61.10%和5.56%;产妇发生感染的单因素主要有年龄、体质指数、糖尿病、生殖器官感染、分娩气候、胎膜早破、产检次数、第二产程时间、手术切口长度和助产士工龄等,组间数据比较差异有统计学意义(P<0.05);BMI≥30、有糖尿病、有生殖器官感染、分娩气候、胎膜早破、超过4次产检、第二产程超2h和助产士工龄<11年等是产妇发生感染的危险因素。结论分娩产妇会阴侧切术后,易发生病原菌感染,其引发病原菌感染的危险因素复杂,病原菌感染对产妇有着严重的生活质量和生命的威胁,高效合理的预防措施是产妇的保障,能有效降低产妇的感染率。

OBJECTIVE To investigate the risk factors of infections in puerpera of episiotomy delivery,so as to provide a theoretical basis for episiotomy delivery of maternal infection and treatment interventions.METHODS A total of 321 cases of puerpera of episiotomy delivery from Jan.2014 to Jan.2016 in the hospital were selected as the study objects.Pathogen types and constitute ratio were analyzed,univariate analysis and multi-factor analysis were carried out,and the data were analyzed by SPSS 18.0.RESULTS Totally 16 patients infected with the infection rate of 4.99%,and 18 strains of pathogens were isolated,including gram-positive bacteria,gram-negative bacteria and fungi,accounting for 33.34%,61.10% and 5.56%.The univariate risk factors of infections in patients were age,body mass index,diabetes,genital infection,childbirth climate,premature rupture of membranes,the number of check-ups,the second stage of labor time,incision length and seniority attending physician,the difference between the two groups was significant（P〈0.05）.Multiple factors physique index（BMI）≥30,diabetes,organ-infection,premature rupture,over 4times birth check,over 2hlabor and not exceeding 11 years were the risk factors.CONCLUSION The use of episiotomy after childbirth,is prone to pathogen infection,risk factors for pathogen infection were complex,pathogen infection in patients has severe threats to quality of life and life,efficient and reasonable precautions can protect the patients,and effectively reduce infection rates.