肛门病手术患者发生医院感染的危险因素分析

Risk Factors Analysis of Nosocomial Infection in Anorectal Surgery Patients

为探讨肛门病手术患者发生医院感染的危险因素，回顾2014年4月至2016年4月于我院择期行手术治疗的813例肛门病患者病例资料，分析患者在医院内并发感染的情况，统计人口学、病理资料，探讨医院感染的危险因素。结果显示，本组813例肛门病手术患者，治疗期间发生术后感染122例（15．01％），其中革兰阴性杆菌感染74例（60．66％），革兰阳性杆菌感染31例（25．41％），真菌感染14例（11．48％），其他病原菌感染3例（2．46％）。术后感染情况与患者年龄、肥胖情况、病程、手术时间、住院时间、使用抗菌药物种类等因素有关，P〈0．05。结果表明，手术治疗肛门疾病患者时，应结合《抗菌药物临床应用指导原则》进行合理抗菌治疗，控制药物滥用，防止耐药菌株形成；术中严格无菌操作，强化肛肠手术操作规范，最大程度缩短手术时间，降低术中感染风险，加强术后护理，对高危因素进行针对性处理，减少手术感染风险。

In order to explore the risk factors of nosocomial infection in anorectal surgery patients,the au- thor reviewed the data of 813 cases with anorectal diseases who underwent elective surgery in author＇s hos- pital from April 2014 to April 2016 ,and analyzed the concurrent infection situation of patients in the hospi- tal, demography and pathological data to explore the risk factors of nosocomial infection.As results, in the813 cases with anoreetal operation, 122 cases （15.01%） were infected after operation during the treatment progress among whom 74 （60.66%） of gram-negative bacilli and 31 （25.41%） of gram-positive bacilli, 14（11.48%） of Fungal infection,and 3 （2.46%） of other pathogens infection.Postoperative infection was re- lated to patients＇ age, obesity, duration of disease, operation time, hospital stay, and whether antimicrobialagents were used （ P 〈0.05）. The results show that in the treatment of patients with anorectal disease it should be combined with antibiotics clinical application guidelines for reasonable antibacterial treatment, to control drug abuse,to prevent the formation of drug-resistant strains; to strictly preforming aseptic tech-nique,to strengthen anorectal operation norms,to shorten the operation time at maximum degree, so that to reduce the risk of intraoperative infection, as well to strengthen postoperative care and target at high risk factors for relevant treatment, decrease the risk of surgical infection.