腹腔镜下异位妊娠急诊手术患者术后切口感染的病原菌特点及影响因素研究

Characteristics of pathogenic bacteria and influencing factors of postoperative incision infection in patients undergoing laparoscopic emergency surgery for ectopic pregnancy

目的旨在探讨如何降低腹腔镜下异位妊娠急诊手术患者术后切口感染的发生率。方法选取在医院妇产科住院行腹腔镜下异位妊娠急诊手术的患者368例为研究对象,对其术后切口感染的发生情况、病原菌特点及影响因素进行回顾性分析。结果368例腹腔镜下异位妊娠急诊手术患者共有29例发生了术后切口感染,术后切口感染的发生率为7.88%。29例发生术后切口感染的患者共检出了34株病原菌,革兰阴性菌、革兰阳性菌以及真菌分别有22株(占64.71%),11株(32.35%)及1株(占2.94%)。Logistic回归分析结果提示:体质指数≥25 kg/m^2、血红蛋白数值<90 g/L、合并糖尿病、夏季手术以及合并盆腔炎等是腹腔镜下异位妊娠急诊手术后切口感染发生的危险因素(OR>1,P<0.05)。结论腹腔镜下异位妊娠急诊手术患者切口感染的发生率较高,其与患者的肥胖程度、失血程度、血糖情况、手术季节及是否合并盆腔炎等关系密切,主要的致病菌为革兰阴性菌。

Objective In order to reduce the incidence of incision infection in patients after emergency surgery for ectopic pregnancy under laparoscopy.Methods A total of 368 patients who underwent laparoscopic emergency surgery for ectopic pregnancy in the obstetrics and gynecology department of hospital were selected as the research object.The incidence of postoperative incision infection,the characteristics of pathogenic bacteria and influencing factors were analyzed retrospectively.Results A total of 29 cases had postoperative incision infection in 368 cases of emergency laparoscopic ectopic pregnancy patients,and the incidence of postoperative incision infection was 7.88%.Total of 34 strains of pathogenic bacteria were detected,including 22 strains(64.71%),11 strains(32.35%)and 1 strain(2.94%)of Gram-negative bacteria,Gram-positive bacteria and fungi,respectively from the 29 cases.Logistic regression analysis showed that body mass index≥25 kg/m^2,hemoglobin value<90 g/L,diabetes mellitus,surgery in summer and pelvic inflammation were the risk factors of incision infection after laparoscopic emergency surgery for ectopic pregnancy(OR>1,P<0.05).Conclusion The incidence of incision infection in patients undergoing emergency surgery for ectopic pregnancy under laparoscope is relatively high,which is closely related to the degree of obesity,blood loss,blood sugar,operation season and pelvic inflammation.The main pathogen is Gram-negative bacteria.