肝胆外科手术切口感染的多因素分析

Analysis of Multiple-factors Inducing Incisional Wound Infection in Hepatobiliary Surgery

目的分析肝胆外科手术切口感染的相关因素。方法选取2016年5月至2018年1月南通市第一老年病医院接收的肝胆外科手术切口感染患者50例作为观察对象,回顾性分析患者的临床资料,对患者的年龄、胆红素、谷丙转氨酶、血红蛋白水平以及手术切口类型、手术耗时及是否使用聚维酮碘冲洗切口等因素与患者的切口感染情况进行记录分析。结果年龄≥60岁、Ⅱ、Ⅲ类手术切口、手术耗时≥120 min和未使用聚维酮碘冲洗切口的患者切口感染占比分别明显高于年龄<60岁、Ⅰ类手术切口、手术耗时<120 min、使用聚维酮碘冲洗切口的患者切口感染占比(P<0.05)。结论对肝胆外科手术患者,应加强无菌观念,提升无菌操作规范性,减少患者的手术耗时,加强术后切口消毒管理的力度,预防切口感染的发生。

Objective To analyze the multiple-factors inducing incisional wound infection in hepatobiliary surgery.Methods A total of 50 patients with incisional wound infection after hepatobiliary surgery admitted to the Nantong First Geriatric Hospital from May 2016 to January 2018 were selected.The clinical data of all patients were retrospectively analyzed.Factors related to wound infection were analyzed,such as age,levels of bilirubin,alanine aminotransferase and hemoglobin,incision type,operative time,use of povidone iodine,etc.Results The proportions of age ≥60 years,Ⅱ and Ⅲ surgical incisions types,operative time ≥120 min,and incision irrigation without povidone iodine were significantly higher than those of age<60 years,Ⅰ surgical incisions type,operative time<120 min,and incision irrigation with povidone iodine,respectively(all P<0.05).Conclusion In order to prevent the infection rate of the surgical incision of patients underwent hepatobiliary surgery,the concept of sterility should be strengthened,the standard of aseptic operation should be improved,the operative time should be shortened,and the management of postoperative incision disinfection should be enhanced.