急性化脓性阑尾炎患儿术后切口感染的临床特点及相关因素分析

Clinical characteristics and related factors of postoperative incision infections in children with acute suppurative appendicitis

目的探究急性化脓性阑尾炎患儿术后切口感染的病原学特点及影响因素。方法选取医院2014年1月-2015年6月收治的269例急性化脓性阑尾炎患儿,回顾性分析患儿术后切口感染的病原菌检出情况及导致感染的影响因素。结果 269例患儿术后共发生切口感染34例,感染率为12.64%;切口分泌物共培养出病原菌61株,其中革兰阴性菌42株,革兰阳性菌19株;多因素分析显示,年龄>6岁、开腹手术、手术时间>1h、自发病至手术的平均时间>12h为急性化脓性阑尾炎患儿术后切口感染的独立影响因素(P<0.05)。结论急性化脓性阑尾炎患儿术后切口感染以革兰阴性菌为主,且与患儿年龄、开腹手术、手术时间、自发病至手术的平均时间密切相关。

OBJECTIVE To explore the etiological characteristics of postoperative incision infections in children with acute suppurative appendicitis and analyze the influencing factors.METHODS A total of 269 children with acute suppurative appendicitis who were treated in hospitals from Jan 2014 to Jun 2015 were enrolled in the study,the isolation rates of pathogens and influencing factors for the infections were retrospectively analyzed.RESULTS Of the 269 children,34 had postoperative incision infections,with the infection rate 12.64%.Totally 61 strains of pathogens were isolated from incision secretions,42 of which were gram-negative bacteria,19 were gram-positive bacteria.Multivariate analysis showed that the more than 6 years of age,laparotomy,operation duration more than1 hour and average time of interval between the onset and surgery more than 12 hours were the independent influencing factors for the postoperative incision infections in the children with acute suppurative appendicitis（P〈0.05）.CONCLUSIONThe gram-negative bacteria are dominant among the pathogens causing the postoperative incision infections in the children with acute suppurative appendicitis,and the infections are closely associated with the age,laparotomy,operation duration and average time of interval between the onset and surgery.