自然分娩产妇会阴切开术后切口感染的危险因素及护理干预对策分析

The risk factors and nursing intervention strategy for parturients with incision infection after spontaneous delivery through episiotomy

目的分析自然分娩产妇会阴切开术后切口感染的危险因素及护理干预对策。方法回顾性收集整理2019年1月至2021年2月收治的605例自然分娩产妇的临床资料,根据产妇会阴切开术后是否发生切口感染分为感染组(n=48)和未感染组(n=557),统计自然分娩产妇会阴切开术后切口感染的发生情况及自然分娩产妇会阴切开术后切口感染发生的影响因素,采用多因素Logistic回归分析自然分娩产妇会阴切开术后切口感染的危险因素。结果605例自然分娩产妇会阴切开术后发生切口感染48例,感染率为7.93%。单因素分析结果显示,感染组年龄>35岁、BMI>28 kg/m^(2)、有糖尿病、生殖道感染、阴道检查>3次、手术时间>30 min、切口长度>3 cm、产程>8 h、胎膜早破的产妇占比均高于未感染组(P<0.05)。多因素Logistic回归分析结果显示,BMI>28 kg/m^(2)、有糖尿病、生殖道感染、阴道检查>3次、手术时间>30 min、胎膜早破均为自然分娩产妇会阴切开术后切口感染的独立危险因素(OR=2.145、1.921、2.392、2.166、2.145、1.939,P<0.05)。结论自然分娩产妇会阴切开术后发生切口感染的概率较高,切口感染的独立危险因素包括BMI>28 kg/m^(2)、有糖尿病、生殖道感染、阴道检查>3次、手术时间>30 min、胎膜早破等,临床可据此对有以上特征的产妇进行针对性护理干预,以降低自然分娩产妇会阴切开术后切口感染发生的风险。

Objective To investigate the risk factors and nursing intervention strategy for parturients with incision infection after spontaneous delivery through episiotomy.Methods The clinical data about 605 parturients who underwent spontaneous delivery in our hospital from January 2019 to February 2021 were retrospectively analyzed,who were divided into incision infection group(n=48)and non-infection group(n=557)according to whether the incision infection occurred after episiotomy.The incidence rate of incision infection after episiotomy and related influencing factors were statistically analyzed by multivariate Logistic regression.Results The incidence rate of incision infection in the parturients after episiotomy was 7.93%(48/605).Univariate analysis results showed that the proportions of parturientsl with age>35 years,BMI>28kg/m^(2),diabetes mellitus,reproductive tract infection,vaginal examination>3 times,operation time>30min,incision length>3cm,labor stage>8h,premature rupture of membranes in incision infection group were significantly higher than those in non-infection group(P<0.05).Multivariate Logistic regression analysis showed that BMI>28kg/m^(2),diabetes mellitus,reproductive tract infection,vaginal examination>3 times,operation time>30min,premature rupture of membranes were the independent risk factors for the occurrence of incision infection after episiotomy(P<0.05).Conclusion The incidence rate of incision infection for parturients who undergo spontaneous delivery via episiotomy is higher,and the independent risk factors for incision infection after episiotomy include BMI>28kg/m^(2),diabetes mellitus history,reproductive tract infection,vaginal examination>3 times,operation time>30min,and premature rupture of membranes.Therefore,it is necessary to take targeted nursing intervention for the parturients who have the above features,so as to decrease the risk of incision infection after episiotomy.