脊柱术后早期医院感染的影响因素及护理对策分析

Analysis of factors and nursing countermeasures affecting early nosocomial infection in patients undergoing spinal surgery

目的探讨影响脊柱手术患者术后早期医院感染的因素及护理对策。方法选取2013年6月—2019年6月在医院进行脊柱手术治疗的654例患者为研究对象,记录患者发生感染的概率,并对感染部位及病原菌分布进行分析,同时对患者感染的危险因素进行单因素及多因素分析。结果654例脊柱手术患者中,出现感染症状患者49例,感染发生率为7.49%,其中以肺部感染所占比例最高,占全部感染患者的46.94%,占全部患者的3.52%。不同性别患者术后早期医院感染发生率差异无统计学意义(P>0.05);不同年龄、住院时间、术中置入材料、合并糖尿病、留置导尿管、手术时间患者术后早期医院感染率差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄、住院时间、术中置入材料、合并糖尿病、留置导尿管、手术时间是影响脊柱手术患者术后早期医院感染的主要因素(P<0.05)。结论患者年龄、住院时间、术中置入材料、合并糖尿病、留置导尿管、手术时间是影响脊柱手术患者术后感染的因素,因此,应通过对患者进行术前评估、早期去除导尿管、科学调整抗菌药物的应用、术后适当开展运动干预及提高护理人员操作能力等方式避免脊柱手术患者术后早期医院感染的发生。

Objective To explore the risk factors and nursing countermeasures affecting early nosocomial infection in patients undergoing spinal surgery.Methods To select 654 cases of patients who underwent spinal surgery in hospital from June 2013 to June 2019 as the study objects.The probability of infection in the patients was recorded,and the location of infection and the distribution of pathogenic bacteria were analyzed.At the same time,the risk factors of patient infection were analyzed by single factor and multiple factor analysis.Results Of the 654 patients undergoing spinal surgery,49 patients had symptoms of infection,and the incidence of infection was 7.49%.Among them,lung infection accounted for the highest proportion,accounting for 46.94%of all infected patients and 3.52%of all patients.There was no statistically significant difference in the incidence of early postoperative nosocomial infections in patients of different genders(P>0.05),there were statistically significant differences in the early postoperative nosocomial infection rates of patients with different ages,hospitalization time,intraoperative materials,diabetes,indwelling catheters and surgical time(P<0.05).Multivariate Logistic regression analysis showed that the patient's age,hospitalization time,intraoperative materials,diabetes,indwelling catheters and surgical time were the main factors that affected early nosocomial infections in patients undergoing spinal surgery(P<0.05).Conclusions The patient’s age,hospitalization time,intraoperative materials,diabetes,indwelling catheters and time of operation were the factors that affected postoperative infection in patients undergoing spinal surgery.Therefore,preoperative evaluation of patients,early removal of catheters,scientific adjustment of the application of antimicrobials,postoperative exercise intervention and improved operation ability of nursing personnel and other methods should be taken to avoid the occurrence of early nosocomial infections in patients undergoing spinal surgery.