前馈控制对妇产科患者手术部位感染的影响

Influence of feedforward control on surgical site infections in patients of gynecology and obstetrics department

目的探究前馈控制对妇产科患者手术部位感染的影响。方法选取医院2015年3月-2016年3月(前馈控制实施后)收治的行子宫切除术患者70例为研究组,对患者行前馈控制,另选2014年3月-2015年3月(前馈控制实施前)62例行子宫切除患者为对照组;对所有患者医院感染分布、手术部位感染情况、抗菌药物使用情况以及病原微生物标本的送检情况、手术中抗菌药物追加使用情况、病原菌检出情况进行分析。结果所有患者发生医院感染共13例,医院感染以手术部位感染为主,占76.92%,其他部位感染较少,差异有统计学意义(P<0.05);研究组手术部位感染率为4.29%低于对照组11.29%,差异有统计学意义(P<0.05);研究组抗菌药物使用率和病原微生物标本送检率分别为(54.29%、64.29%)与对照组(85.48%、32.26%)比较,差异有统计学意义(P<0.05);研究组抗菌药物追加使用率为36.00%,明显低于对照组71.43%,差异有统计学意义(P<0.05);10例手术部位感染患者的临床标本共检出7株病原菌,其中粪肠球菌3株占42.86%;大肠埃希菌2株占28.57%;金黄色葡萄球菌1株占14.29%;肺炎克雷伯菌1株占14.29%。结论前馈控制对妇产科患者手术部位感染能够发挥很好的控制作用,可有效降低妇产科患者手术部位感染率。

OBJECTIVE To explore the influence of feedforward control on surgical site infections in patients of gynecology and obstetrics department.METHODS Totally 70 patients who underwent hysterectomy in the hospital from Mar 2015 to Mar 2016（after the implementation of feedforward control）were chosen as the study group,for whom the feedforward control was carried out,and 62 patients who received the hysterectomy from Mar 2014 to Mar 2015（before the implementation of feedforward control）were set as the control group.The distribution of nosocomial infections,incidence of surgical site infections,utilization rates of antibiotics,submission rates of pathogenic microorganisms,intraoperative additional utilization rates of antibiotics and isolation rates of pathogens were statistically analyzed.RESULTS Totally 13 patients had nosocomial infections,of whom 76.92%had surgical site infections,as compared with the patients with other sites of infections,there was significant difference（P〈0.05）.The incidence of surgical site infections of the study group was 4.29%,lower than 11.29%of the control group,and there was significant difference.The utilization rate of antibiotics was 54.29%in the study group,85.48%in the control group;the submission rate of pathogenic specimens was 64.29%in the study group,32.26%in the control group,and there was significant difference（P〈0.05）.The additional utilization rate of antibiotics of the study group was 36.00%,lower than 71.43%of the control group,and there was significant difference（P〈0.05）.A total of 7 strains of pathogens were isolated from clinical specimens of 10 patients with surgical site infections,including 3（42.86%）strains of Enterococcus faecalis,2（28.57%）strains of Escherichia coli,1（14.29%）strain of Staphylococcus aureus,and 1（14.29%）strain of Klebsiella pneumoniae.CONCLUSION The feedforward control can achieve significantly effect on control of the surgical site infections in the patients of gynecology and obstetrics department and effectively reduce the incidence of the surgical site infections.