妇科术后切口感染的影响因素分析及其对医疗费用的影响

Influencing factors of incision infection after gynecological surgery and its impact on medical expenses

目的分析妇科术后切口感染的影响因素及其对医疗费用的影响。方法选取2014-2016年于广西某三级妇幼保健院住院病区行妇科手术的患者3 560例,根据术后切口是否发生感染分为感染组27例与未感染组3533例。回顾性分析所有患者一般资料,术后切口感染影响因素分析采用多因素非条件Logistic回归分析,比较两组患者的手术治疗费用、药品费用和医疗总费用。结果两组患者年龄、术前住院天数、手术输血、切口分类、住院天数和贫血比较,差异有统计学意义(P<0.05)。多因素非条件Logistic回归分析结果显示,术前住院天数、手术输血和贫血为术后切口感染的影响因素(P<0.05)。感染组患者手术治疗费用、药品费用和医疗总费用高于非感染组(P<0.05)。结论缩短术前住院时间,加强手术输血管理,合理应用抗菌药和改善患者贫血状况有利于预防和降低妇科手术切口感染的发生,并可进一步降低患者医疗费用。

Objective To analyze the influencing factors of incision infection after gynecological surgery and its impact on medical expenses.Methods A total of 3 560 cases of patients who underwent gynecologic surgery were selected from 2014 to 2016 in A Three-level Maternal and Child Health Care Hospital of Guangxi,which were divided into infection group(n=27) and non infection group(n=3 533) according to whether incision infection occurred.The general data of all patients were retrospectively analyzed.Influencing factors of wound infection after operation were analyzed by multivariate unconditional Logistic regression analysis.The operation cost,drug cost and total medical cost of the two groups were compared.Results There were significant differences in age,preoperative hospitalization days,operative blood transfusion,incision classification,hospitalization days and anemia between the two groups(P<0.05).Multivariate unconditional Logistic regression analysis showed that preoperative hospitalization days,operative blood transfusion and anemia were the influencing factors of postoperative incision infection(P<0.05).The infected group operation cost,drug cost and total medical cost were higher than the non infected group(P<0.05).Conclusion Shortening the preoperative hospital stay,strengthening the management of blood transfusion,rational use of antibiotics and improving anemia of patients are conducive to preventing and reducing the incidence of incision infection in gynecological surgery,and can further reduce the medical costs of patients.