39例剖宫产手术切口感染危险因素分析

Related Risk Factors Analysis in 39 Cases Incision Infection After Cesarean Section

目的探讨剖宫产术后发生切口感染的相关危险因素,为预防和降低切口感染提供可靠依据。方法回顾分析我院产科2014年3月—2015年8月行剖宫产术的885例产妇临床资料,选择发生切口感染的39例作为观察组,按1∶1随机选择无切口感染剖宫产产妇39例作为对照组,比较两组产妇一般情况及手术方面相关指标上的差异,统计分析剖宫产术后切口感染的病原菌分布及相关危险因素。结果 885例行剖宫产术的产妇中共发生切口感染39例,切口感染率为4.41%;检出病原菌以大肠埃希菌和金黄色葡萄球菌为主,分别占38.46%和23.08%,其次为表皮葡萄球菌和B族链球菌,分别占12.82%和10.26%;观察组的年龄、体质量指数、手术时间、基础疾病、胎膜早破以及疤痕子宫均显著高于对照组,差异有统计学意义(P<0.05)。结论剖宫产术后发生切口感染的病原菌以大肠埃希菌和金黄色葡萄球菌为主;产妇的年龄、体质量指数、手术时间、基础疾病、胎膜早破以及疤痕子宫是剖宫产术后切口感染的主要危险因素。

Objective To explore the related risk factors for incisional infections in cesarean section and provide sci- entific theoretical evidence for the preventive treatment and decrease of incision infections. Methods Retrospective analysis for the clinical data of 885 pregnant women who underwent cesarean section from Mar 2014 to Aug 2015, a total of 39 cases of incision infection following cesarean section were studied as observation group, and 39 cases of no incision infection follow- ing cesarean section were randomly selected by 1 ： 1 as control group, to compare the indicator - related differences in mater- nal and surgery between the two groups. Then the species of pathogens causing the postoperative incision infections and the related risk factors for nosocomial infections were statistically analyzed. Results Totally 39 of 885 pregnant women showed incisional infections after cesarean section, with a rate of 4. 41%. Escherichia coli and Staphylococcus e aureus were the main bacteria, which accounted for 38.46% and 23.08% , respectively, followed by Staphylococcus epidermidis （ 12. 82% ） and Group B streptococcui （ 10.26% ）. The age of pregnant women, BMI value, operation duration, basic diseases, prema- ture rupture of membrane and cicatricial uterus of pregnant women with incision infections were significantly higher than those of the pregnant women without incision infections. And the differences were statistically significant （ P 〈 0. 05 ）. Conclusion Escherichia coli and Staphylococcus e aureus were the main bacteria for incisional infections in cesarean section. The ages of pregnant women, BMI value, operation time, basic diseases, premature rupture of membrane and cicatricial uterus of preg- nant women with incision infections were the main risk factors of incision infections in cesarean section.