子宫切除术后患者医院感染的危险因素Logistics回归分析

Logistics regression analysis on risk factors related to nosocomial infection after hysterectomy

目的 探讨子宫切除术后患者医院感染的危险因素,为减少患者术后感染提供理论依据。方法 选取妇科2014年11月～2015年10月进行子宫切除术治疗的患者435例进行回顾性调查分析。运用SPSS13.0软件对患者的临床资料进行单因素分析和多因素Logistic回归分析,观察术后发生感染的危险因素。结果 医院感染率为21.8%。主要为泌尿道感染,占29.5%;其次为切口感染和呼吸道感染,各占25.0%和17.0%。单因素分析结果有统计学意义的变量为年龄、手术时间、手术范围、术前住院天数、手术方式和术中失血量。多因素非条件Logistic回归分析结果显示,手术时间≥1.5 h（OR=2.599,95%CI 1.465～4.611）、经腹手术（OR=4.277,95%CI 2.136～8.563）、术前住院时间≥5 d（OR=1.956,95%CI 1.169～3.273）、子宫全切术（OR=10.029,95%CI 1.339～75.112）为子宫切除术后患者医院感染的危险因素。结论 子宫切除术后患者医院感染主要与手术时间、手术范围、术前住院天数、手术方式有关。

Objective To explore the risk factors for nosocomial infection in the patients after hysterectomy, so as to provide theoretical basis for reducing infection after hysterectomy. Methods A total of 435 patients after hysterectomy in department of gynecology from November 2014 to October 2015 were retrospectively analysis. The univariate analy- sis and the multivariate Logistic regression analysis were conducted on the clinical data of patients, SPSS 13.0 software was used for statistical analysis, and then infection-related risk factors were observed. Results The nosocomial infec- tion rate was 21.8%. The most common infection was urinary tract infection （29.5%）, surgical-site infection （25.0%） and respiratory tract infection （17.0%）. Through the univariate analysis, nosoeomial infection in the patients after hys- terectomy had significantly associations with age, operation duration, extent of surgery, the length of hospital stay be- fore surgery, types of surgery, intraoperative blood loss. The multivariate Logistic regression analysis showed that the risk factors were operation duration≥ 1.5 h（OR=2.599,95%C1 1.465-4.611）, abdominal hysterectomy（OR=4.277,95% CI 2.136-8.563）, the length of hospital stay before surgery≥5 days （0R=1.956,95%CI 1.169-3.273） and total hys- terectomy （0R=10.029,95%CI 1.339-75.112）. Conclusion Nosocomial infection in the patients after hysterectomy could attribute to operation duration, extent of surgery, the length of hospital stay before surgery, types of surgery.