摘要
目的 :探讨导致外科手术患者发生手术部位感染(SSI)的危险因素,分析对其进行解决的措施。方法 :回顾性地研究在四川省营山县中医医院进行外科手术的1928例患者的临床资料。统计这些患者发生SSI的情况,分析导致其发生SSI的原因,探讨对其进行解决的措施。结果 :调查的结果显示,在这1928例患者中,有94例患者发生了SSI,其SSI的发生率为4.88%。调查的结果显示,年龄≥60岁的患者其SSI的发生率高于年龄<60岁的患者,BMI≥24的患者其SSI的发生率高于BMI<24的患者,有合并症的患者其SSI的发生率高于没有合并症的患者,没有规范使用抗生素进行治疗的患者其SSI的发生率高于规范使用抗生素进行治疗的患者,术前存在炎症反应的患者其SSI的发生率高于术前不存在炎症反应的患者,进行开放式手术的患者其SSI的发生率高于进行腹腔镜手术的患者,进行急诊手术的患者其SSI的发生率高于择期进行手术的患者,进行手术的时间≥90 min的患者其SSI的发生率高于进行手术的时间<90 min的患者,手术切口为II类切口的患者其SSI的发生率高于手术切口为I类切口的患者,差异具有统计学意义(P<0.05)。结论 :年龄≥60岁、BMI≥24、存在合并症、未规范使用抗生素进行治疗、术前存在感染、进行急诊手术、进行手术的时间≥90 min、进行II类切口手术、进行开放式手术都是导致外科手术患者发生SSI的危险因素。医院应加强对此类患者的管理,做好术前的评估及准备工作,控制其原发病和合并症,严格进行无菌操作,尽量避免急诊,为患者合理使用抗生素进行治疗,以降低其SSI的发生率。
Objective To investgate risk factors for surgical site infection（SSI） and to analyses solution of prevention. Methods Restrospectively analyses material of 1928 cases of the patients accepted surgery in Ying Shan County Traditional Chinese Medical Hospitals in Sichuan Province. To analyses situation and reason of SSI,and to investgate solution of prevention. Results The results of survey shows that 94 cases occurred surgical site infection, the incidence of SSI was 4.88%. The results of survey shows that incidence of SSI in the patients older than 60 years was higher than that in patients older than 60 years. Incidence of SSI in the patients whose BMI ≥ 24 was higher than the patients whose BMI〈24, Incidence of SSI in the patients who has complications was higher than in the patients who has no complications. Incidence of SSI in the patients without standardized use of antibiotics was higher than that in the patients with standardized use of antibiotics. Incidence of SSI in the patients who has inflammatory response before surgery was higher than that the patients who without inflammatory response before surgery. Incidence of SSI in the patients who accepted open surgery is higher than that the patients who accepted laparoscope surgery. Incidence of SSI in the patients who accepted emergency surgery was higher than that in the patients who didn＇t accepted emergency surgery. Incidence of SSI in the patients whose operative time longer than 90 minutes than that the patients whose operative time shorter 90 minutes. Incidence of SSI in the patients with type II operative incision was in the patients with type I operative incision. The difference have statistical significant（P〈0.05）. Conclusion Ages ≥ 60 years, BMI ≥ 24,with complications, without standardized use of antibiotics, has inflammatory response before surgery, with type II operative incision, accepted open surgery, accepted emergency surgery, operative time longer than 90 minutes are the factors of SII. We should strengthen management for the patients with the factors of SII, getting preoperative evaluation and preparation, control primary diseases and complications of patients, strictly aseptic technique, avoid misdiagnoses as much as possible, standardized use of antibiotics, to decrease the incidence.
