2017-2021年铜陵市某医院产妇产后感染发生现状及影响因素研究

Incidence and influencing factors of postpartum infection in a hospital in Tongling City,2017-2021

目的对铜陵市某医院产妇产后感染发生现状及影响因素进行分析,为产后感染预防控制措施的调整及制定提供科学依据。方法2017年1月1日至2021年12月31日铜陵市某妇幼专科医院的产妇病例资料来源于医院信息系统、实验室检测系统及产妇病案档案,采用描述性分析方法对产妇产后感染发生情况及病原菌特征等进行分析,并采用单、多因素分析方法对产后感染发生影响因素进行分析。结果18942名产妇年龄22~54岁,平均(27.83±5.42)岁,孕周26+6至42+1周,平均孕周(39.21±1.29)周。112例产妇产后发生感染,感染率为0.59%,感染部位主要为呼吸系统、生殖道、手术切口及泌尿系统,分别占41.96%、20.54%、19.64%、11.61%。112例感染者中共检出126株病原菌,以大肠埃希菌(28.57%)、肺炎克雷伯菌(19.84%)、粪肠球菌(19.05%)及金黄色葡萄球菌(12.70%)为主。多因素分析结果显示年龄≥35岁(OR=3.873)、合并妊娠期糖尿病(OR=3.232)、合并妊娠期高血压(OR=3.016)、产后出血(OR=2.702)、瘢痕子宫(OR=7.862)、前置胎盘阴道反复出血(OR=6.322)、胎膜早破(OR=3.177)、侵入性操作(OR=7.721)、分娩时长≥8 h(OR=2.344)、分娩后血红蛋白<90 g/L(OR=4.238)是产妇发生产后感染的独立危险因素。结论铜陵市某医院产妇产后感染以呼吸系统、生殖道、手术切口及泌尿系统感染为主,年龄、妊娠合并症、产后出血、瘢痕子宫、前置胎盘阴道反复出血、胎膜早破、侵入性操作、分娩时长、分娩后血红蛋白与产妇产后感染相关。

Objective To analyze the incidence and influencing factors of postpartum infection among parturients in a hospital in Tongling City,to provide a scientific basis for the adjustment and formulation of prevention and control measures of postpartum infection.Methods From January 1,2017,to December 31,2021,the maternal case data of a maternal and child hospital in Tongling City were derived from the hospital information system,laboratory detection sys‐tem,and maternity medical records.The descriptive analysis method was used to analyze the incidence of postpartum infec‐tion and the characteristics of pathogens,and univariate and multivariate analysis methods were used to analyze the influ‐encing factors of postpartum infection.Results In this study,18942 parturients included in the analysis were 22-54years old,with an average of(27.83±5.42)years old;gestational weeks were 26+6to 42+1,with an average of(39.21±1.29)weeks.Postpartum infection in 112 parturients,and the infection rate was 0.59%.The infection was mainly in the respiratory system,reproductive tract,surgical incision,and urinary system,accounting for 41.96%,20.54%,19.64,and 11.61%,respectively.A total of 126 strains of pathogenic bacteria were detected in 112 infected patients,mainly in‐cluding Escherichia coli(28.57%),Klebsiella pneumoniae(19.84%),Enterococcus faecalis(19.05%),and Staphylococ‐cus aureus(12.70%).Multivariate analysis showed that age≥35 years(OR=3.873),complicated with gestational diabetes(OR=3.232),complicated with gestational hypertension(OR=3.016),postpartum hemorrhage(OR=2.702),scar uterus(OR=7.862),placenta previa vaginal repeated bleeding(OR=6.322),premature rupture of membranes(OR=3.177),invasive procedures(OR=7.721),length of delivery≥8 h(OR=2.344),post‐delivery hemoglobin<90 g/L(OR=4.238)were independent risk factors for postpartum infection.Conclusions The postpartum infection of parturients in a hospital in Tongling City is mainly an infection of the respiratory system,reproductive tract,surgical incision,and surgical incision.Age,pregnancy complications,postpartum hemorrhage,scar uterus,placenta previa vaginal repeated bleeding,premature rupture of membranes,invasive procedures,length of delivery,and post‐delivery hemoglobin are related to postpartum infection of parturients.