成人腹股沟疝开放式无张力修补术术后手术部位感染高发因素分析

Analysis of the high incidence factors of infection after open tension-free inguinal hernia repair in adults

目的探讨成人腹股沟疝开放式无张力修补术术后手术部位感染高发的危险因素及干预措施。方法选择2010年1月至2017年1月,四川省阿坝藏族羌族自治州人民医院1 500例成人腹股沟疝开放式无张力修补术患者的临床资料,对患者的手术部位感染情况进行单因素回顾性分析。结果患者的年龄、手术时间、预防性应用抗生药物和合并基础疾病指标结果比较,差异有统计学意义(P<0.05),且危险因素感染关联强度由低到高依次为年龄、合并基础疾病和手术时间;分析患者手术部位感染年龄因素和危险等级可知,手术部位感染发生率随着年龄增长、危险等级的增高而显著的提高;革兰阳性菌对青霉素类和磺胺甲硝唑呈较高的耐药率,革兰阴性菌普遍对氨苄西林耐药率较高。结论成人腹股沟疝开放式无张力修补手术部位感染的危险因素为手术时间、合并基础疾病、年龄;针对感染患者应选用针对性抗感染药物进行治疗。

Objective To explore risk factors for surgical site infection after tension-free inguinal hernia repair in adults and intervention measures. Methods We retrospectively analyzed the clinical date of 1 500 adult patients treated open tension-free inguinal hernia repair from January 2010 to January 2017 in the People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture. The surgical site infection of the patients was retrospectively analyzed by single factor. Results The results related indicators of age, operation time, prophylactic antibiotic drugs and underlying diseases was statistically significant (P<0.05). Differences in the intensity of the risk factors associated with infection from low to high: age, underlying diseases and operation time. By analyzing surgical site infections in patients' age factor and the level of danger, we found that surgical site infection incidence with age and the risk level significantly increasing. The resistance rate of gram-positive bacteria to penicillin and sulfamethoxazole file was higher, and the resistance rate of gram-negative bacteria to ampicillin was higher generally. Conclusion The risk factors for surgical site infection after open tension-free inguinal hernia repair in adults are operation time, underlying diseases and age. Targeted anti-infective drugs should be used for treatment of infected patients.