妇科肿瘤术后患者发生盆腔感染的危险因素及控制措施

Risk factors and control measures for postoperative pelvic infections in patients with gynecological tumors

目的探讨妇科肿瘤患者术后盆腔感染的危险因素。方法回顾性分析420例妇科肿瘤患者的年龄、手术持续时间、住院时间、是否合并糖尿病或高血压、术前盆腔感染史、手术方式、术前化疗、术后是否使用抗菌药物及术后是否留置导管等因素与盆腔感染的相关性。结果 420例妇科肿瘤患者中,发生盆腔感染38例,感染率为9.0%。单因素分析结果显示,年龄>60岁、手术持续时间>2 h、住院时间>7 d、合并糖尿病或高血压、术前盆腔感染史、开放式手术、术前化疗、术后未使用抗菌药物及术后留置导管患者盆腔感染率均较高(均P<0.05)。多因素分析显示,其盆腔感染率与患者的年龄(OR=1.79,P=0.012)、手术持续时间(OR=1.83,P=0.021)、术前盆腔感染史(OR=1.97,P=0.023)、手术方式(OR=1.66,P=0.012)、术后未使用抗菌药物(OR=1.49,P=0.035)及术后留置导管(OR=1.53,P=0.028)等因素相关。结论妇科肿瘤患者术后盆腔感染率与年龄、手术持续时间、术前盆腔感染史、手术方式、术后未使用抗菌药物及术后留置导管等因素相关。

Objective To analyze the risk factors of postoperative pelvic infections in patients after the surgery of gynecological tumors. Methods Four-hundreds-and-twenty patients with gynecological tumors were retrospectively analyzed. The association between postoperative pelvic infection and factors including patient age,duration of operation,duration of hospital stay,combination with diabetes or hypertension,preoperative pelvic infection history,surgical approach,preoperative chemotherapy,postoperative application of antibiotics,and indwelling catheter after operation were analyzed.Results Pelvic infection occurred in 38 out of the 420 patients with gynecological tumors,with an infection rate of 9. 0%.Univariate analysis revealed that the incidence of postoperative pelvic infection was higher in patients with 60-year of age, 〉2 h surgery duration, 〉7 d hospital stay,combination with diabetes or hypertension,preoperative pelvic infection,open operation,preoperative chemotherapy,no postoperative antibiotics,and postoperative indwelling catheter（ all P〈0. 05）. Moreover,multivariate analysis suggested that postoperative pelvic infections were associated with age（ OR = 1. 79,P = 0. 012）,duration of operation（ OR = 1. 83,P = 0. 021）,preoperative pelvic infection（ OR = 1. 97,P = 0. 023）,surgical approach（ OR = 1. 66,P = 0. 012）,no postoperative antibiotics（ OR = 1. 49,P = 0. 035） and postoperative indwelling catheter（ OR = 1. 53,P = 0. 028）. Conclusion The incidence of postoperative pelvic infection in gynecological tumor patients were related with age,surgery duration,preoperative pelvic infection,surgical approach,no postoperative antibiotics,and postoperative indwelling catheter.