高龄产妇剖宫产术后切口感染的危险因素及预后分析

Risk factors for postoperative incision infections in elderly parturient women undergoing cesarean section and analysis of prognosis

目的分析高龄产妇剖宫产术后切口感染的危险因素,以期为临床预防术后切口感染提供参考。方法回顾性分析2011年3月-2015年6月医院接受剖宫产的1023例高龄产妇临床资料,分析术后切口感染率及感染病原菌类型,采用Logistic回归分析术后切口感染相关危险因素。结果 1023例高龄产妇术后切口感染118例,感染率为11.53%;118例感染患者送检标本分离病原菌114株,其中革兰阴性菌86株占75.44%,革兰阳性菌24株占21.05%,真菌4株占3.51%;单因素分析结果显示:体质量指数>25kg/m2、术中出血量>500ml、手术时间>60min、侵入性操作>4次,合并基础疾病为术后切口感染的相关因素(P<0.05);多因素Logistic回归分析结果显示:体质量指数、术中出血量、基础疾病、院内侵入性操作次数等为高龄产妇术后切口感染的独立危险因素。结论高龄产妇剖宫产术后切口感染的危险因素较多,医护人员应制定针对性的护理干预对策进行预防,以期降低术后医院切口感染率。

OBJECTIVE To investigate the risk factors for postoperative incision infections in elderly parturient women undergoing cesarean section so as to provide guidance for clinical prevention of postoperative incision infec-tions.METHODS The clinical data of 1023 elderly parturient women who underwent the cesarean section in the hospital from Mar 2011 to Jun 2015 were retrospectively analyzed,the incidence of postoperative incision infections and species of pathogens were observed,and the logistic regression analysis was performed for the related risk fac-tors for the postoperative incision infections.RESULTS Of the 1023 elderly parturient women undergoing cesarean section,118 had the postoperative incision infections,with the infections rate 11.53%.A total of 114 strains of pathogens were isolated from the submitted specimens that were obtained from the 118 patients with the infec-tions,of which 86（75.44%）were gram-negative bacteria,24（21.05%）were gram-positive bacteria,and 4（3. 51%）were fungi.The result of univariate analysis showed that the body mass index more than 25kg/m2,intraop-erative blood loss more than 500ml,operation duration more than 60min,more than 4 times of invasive operation and complication with underlying diseases were the related factors for the postoperative incision infections（P〈0. 05）.The result of multivariate logistic regression analysis indicated that the body mass index,intraoperative blood loss,underlying diseases and number of times of nosocomial invasive operation were the independent risk factors for the postoperative incision infections in the elderly parturient women.CONCLUSION There are a variety of risk factors for the postoperative incision infections in the elderly parturient women undergoing the cesarean section, and it is necessary for the health care workers to take targeted nursing interventions so as to reduce the incidence of the postoperative incision infections.