腹腔镜全子宫切除术后感染影响多因素Logistic回归分析及干预效果研究

Multivariate Logistic Regression Analysis and Intervention Effect Study of Infection after Laparoscopic Total Hysterectomy

目的探讨腹腔镜全子宫切除术后感染影响多因素Logistic回归分析及干预效果。方法选择2020年5月至2022年5月腹腔镜全子宫切除术患者132例为对象,根据患者术后是否发生感染分为感染组(n=21例)和非感染组(n=111例)。统计感染病例感染部位及构成比;查阅病例资料,对患者术后感染影响因素进行单因素和多因素Logistic回归分析,并采取相应的措施干预。结果132例腹腔镜全子宫切除术患者,术后21例发生感染,发生率为15.91%,感染类型以泌尿系感染、肺部感染和切口感染为主,分别占52.38%、33.33%和14.29%。单因素和多因素Logistic回归分析结果表明:年龄(β1.213,OR 3.582,95%CI 2.482~6.313)、手术时间(β1.563,OR 6.413,95%CI 5.682~8.452)、侵入性操作(β1.454,OR 4.083,95%CI 3.235~4.572)、留置尿管(β2.934,OR 1.034,95%CI 0.283~4.394)、术中出血量(β1.691,OR 1.593,95%CI 1.241~1.786)、绝经(β1.336,OR 1.246,95%CI 0.987~1.583)、住院时间(β2.694,OR 14.789,95%CI 2.231~18.045)均为腹腔镜全子宫切除术后感染发生的危险因素(P<0.05)。结论腹腔镜全子宫切除术后感染发生率较高,且受到的影响因素较多,不同因素能相互作用及影响,围手术期应针对可能的影响因素采取干预措施,巩固手术效果,降低术后感染率。

Objective To explore the multifactorial logistic regression analysis and intervention effects of infection after laparoscopic total hysterectomy.Methods A total of 132 patients who underwent laparoscopic total hysterectomy from May 2020 to May 2022 were selected as the study subjects.They were divided into an infected group(n=21 cases)and a non infected group(n=111 cases)based on whether they experienced infection after surgery.Statistically analyze the infection site and composition ratio of infection cases;Review case data,conduct univariate and multivariate logistic regression analysis on the influencing factors of postoperative infection in patients,and take corresponding measures for intervention.Results Among 132 patients who underwent laparoscopic total hysterectomy,21 cases developed infections postoperatively,with an incidence rate of 15.91%.The main types of infections were urinary tract infections,lung infections,and incision infections,accounting for 52.38%,33.33%,and 14.29%,respectively.The results of univariate and multivariate logistic regression analysis indicate that age(β1.213,OR 3.582,95%CI 2.482-6.313),surgical time(β1.563,OR 6.413,95%CI 5.682-8.452),invasive operation(β1.454,OR 4.083,95%CI 3.235-4.572),indwelling catheter(β2.934,OR 1.034,95%CI 0.283-4.394),intraoperative bleeding volume(β1.691,OR 1.593,95%CI 1.241-1.786),menopausal(β1.336,OR 1.246,95%CI 0.987-1.583),length of hospital stay(β2.694,OR 14.789,95%CI 2.231-18.045)are all risk factors for postoperative infection after laparoscopic total hysterectomy(P<0.05).Conclusions The incidence of infection after laparoscopic total hysterectomy is relatively high,and there are many influencing factors.Different factors can interact and affect each other.Intervention measures should be taken during the perioperative period to consolidate the surgical effect and reduce the postoperative infection rate.