宫外孕术后发生医院感染的影响因素分析

Analysis of influencing factors of nosocomial infection after ectopic pregnancy

目的探讨宫外孕术后发生医院感染的影响因素。方法选取2019.1-2020.12月在洛宁县妇幼保健院妇科病区住院行宫外孕手术的患者67例为研究对象,统计患者术后医院感染发生率及其感染部位、病原菌的分布特点及影响因素。结果67例宫外孕术后患者共有13例患者发生医院感染,以呼吸道感染与泌尿系统感染为主,感染率为19.40%,13例感染患者共检出29株病原菌,革兰阳性菌16株(55.17%),革兰阴性菌10株(34.48%),真菌3株(10.35%);多因素Logistic回归分析结果显示,患者合并基础疾病、术前应用甲氨蝶呤、手术时间大于2h、住院大于4天、以及开腹手术是医院感染的独立影响因素(P<0.05)。结论对于宫外孕患者术后发生医院感染的病菌以革兰阳性菌为主,且多为呼吸系统与泌尿系统感染。合并基础疾病、术前应用甲氨蝶呤、手术时间大于2h、住院大于4天以及开腹手术的宫外孕术后患者更易发生医院感染。

Objective To explore the influencing factors of nosocomial infection after ectopic pregnancy.Methods A total of 67 patients who underwent ectopic pregnancy surgery in the Department of Obstetrics and Gynecology of Luoning County Maternity and Child Health Hospital from 2019.1 to 2020.12 were selected as the research objects.The incidence of postoperative nosocomial infections and the distribution characteristics of infection sites,pathogenic bacteria and influencing factors of patients were counted.Results A total of 13 cases of 67 patients with ectopic pregnancy had nosocomial infections,mainly respiratory infections and urinary system infections.The infection rate was 19.40%.A total of 29 pathogenic bacteria and 16 Gram-positive bacteria were detected in 13 infected patients(55.17%),10 strains of gram-negative bacteria(34.48%),3 strains of fungi(10.35%);multivariate logistic regression analysis showed that patients with underlying diseases,surgery time greater than 2 h,hospitalization greater than 4 days,and laparotomy are hospitals Independent influencing factors of infection(P<0.05).Conclusion For patients with ectopic pregnancy,nosocomial infections are mainly caused by Gram-positive bacteria,and most of them are respiratory and urinary system infections.Patients with ectopic pregnancy combined with underlying diseases,operating time longer than 2 hours,hospitalized for longer than 4 days,and laparotomy are more likely to develop nosocomial infections.