妇产科腹部手术切口感染危险因素分析及预防对策

Risk factors of abdominal surgery incision infection in gynecology and obstetrics and related preventive measures

目的调查导致妇产科腹部手术切口感染的危险因素,提出预防对策。方法回顾性收集139例妇产科腹部切口手术患者的临床资料,根据术后是否发生切口感染分为感染组(n=8)和非感染组(n=131)。对切口感染影响因素进行分析,对可能的危险因素进行Logistic回归分析。结果 8例切口感染,感染率为5. 76%,共检出10株病原菌。多因素Logistic回归分析显示,年龄> 60岁[OR=5. 156,95%CI (2. 925,8. 241)]、体质量指数> 23 kg/m^2[OR=6. 731,95%CI (2. 487,10. 021)]、手术时间>120 min[OR=5. 014,95%CI (2. 625,8. 323)]、合并基础疾病[OR=5. 550,95%CI (2. 448,8. 204)]、未预防性使用抗菌药[OR=4. 955,95%CI (2. 697,7. 691)]是妇产科经腹手术术后发生切口感染的危险因素。结论应合理评估患者自身疾病状态,严格执行手术流程和无菌操作原则,合理使用抗菌药物,积极预防妇产科腹部手术切口感染。

Objective To investigate the potential risk factors of abdominal surgery incision infection in gynecology and obstetrics and to provide related preventive measures. Methods The clinical data of 139 gynecology and obstetrics patients undergoing the abdominal incision surgery were retrospectively analyzed. Patients were divided into the infection group （n = 8 ） and non-in- fection group （n =131 ）. The potential risk factors of abdominal surgery incision infection were analyzed by logistic regression. Results There were 8 （5.76 % ） cases of incision infection, and 10 strains of pathogens were isolated. The logistic analysis showed that age over 60 I OR = 5. 156, 95%CI （2.925, 8.241） ], body mass index 〉23 kg/m2 IOR =6.731, 95%CI （2.487, 10. 021） ], operation duration 〉 120 min I OR = 5. 014, 95% CI （2. 625, 8. 323 ） ], combined original diseases [ OR = 5. 550, 95 % CI （2. 448, 8. 204 ） ], without prophylactic antibiotics [ OR = 4. 955, 95 % CI （2. 697, 7. 691 ） ] are potential reasons of abdominal incision infection after gynecology and obstet- rics surgeries. Conclusion It is required to evaluate patients＇illness condition, strictly perform the operation procedure and aseptic technique and proper use of antibacterial agents, in order to prevent the abdominal incision infection after gynecology and obstetrics surgeries.