2015年某医院普通外科手术部位感染相关因素分析

Related factors and countermeasures of surgical site infections for department of general surgery in Chengde Medical Hospital in 2015

目的评估普通外科手术部位感染(SSI)的影响因素,提高目标监测的质量,为降低SSI发生率提供临床理论依据。方法依据医院感染监测规范于2015年1月1日至12月31日对普通外科手术部位感染进行目标性检测。监测期间共实施手术920例。采取SPSS19.0软件对相关数据进行统计学分析。结果 SSI综合发生率为4.35%;随着手术危险指数的增加,手术部位感染率升高。分离出病原菌17株,其中大肠埃希菌数量最多为11株。择期手术SSI发生率为2.40%,急诊手术SSI发生率为10.85%,差异有统计学意义(χ2=27.997,P<0.05)。普通外科以Ⅱ类切口手术为主,Ⅱ类切口手术的SSI发生率为2.27%,Ⅲ类切口手术的SSI发生率为21.90%,Ⅰ类切口手术无SSI发生;手术时间大于3h的SSI发生率为7.27%,≤3h的SSI发生率为3.71%,差异有统计学意义(χ2=4.136,P<0.05);切口长度大于或等于10cm的SSI发生率为13.11%,<10cm的SSI发生率为1.82%,差异有统计学意义(χ2=48.966,P<0.05)。结论 NNIS评分、切口类型、手术类型、手术持续时间等均可能成为SSI的危险因素。

Objective To assess the impact factors of surgical site infection（SSI） in the department of general surgery,the improve the quality of the target of monitoring, provide clinical theoretical basis for reducing the incidence of SSI. Methods In 2015,920 patients who underwent general surgery was took in the targeted monitoring of SSI. SPS819.0 software was used to analyzing the data. Results The infection rate was 4.35% ;Surgical site infection rate was rising,with the increase of NNIS. 17 patho- gens were isolated,including 11 Escherichia colis which was the most. The incidence of the $SI was 2.40% between two groups in the patients who underwent the elective surgeries 10, 85 ~~0 ,in the patients who underwent emergency surgery, there was significant difference between two groups（X2 =27. 997 ,P〈0.05）. The type Ⅱ surgical incision was smain type in the department of general surgery, the incidence of the type Ⅱ surgical incision was 2.27%, the incidence of the type ~] surgical incision was 21.90%, no SSI occurred in the type I surgical incision; SSI incidence of surgery time which was more than 3 h was 7. 27%, less than 3 h was 3.71%, there was significant difference between two groups （χ2 = 4.136, P〈0.05） ;the SSI incidence of the incision length ≥ 10 cm was 13.110% ,less than 10 cm was 1.82%, the difference was statistically significant （χ2=48. 966, P〈0.05）. Conclusion NNIS score, wound type, type of surgery, duration of surgery may become the risk factors SSI.