胆囊切除术后医院感染的危险因素分析

Analysis of risk factors for nosocomial infection after cholecystectomy

目的:探讨胆囊切除术后医院感染的危险因素。方法:回顾性调查2023年1月至12月在河南省胸科医院接受治疗的59例胆囊切除术患者,依据是否发生医院感染,将患者分为感染组、未感染组。统计所有患者的一般资料、治疗情况,分析医院感染的危险因素。结果:59例患者中,医院感染9例(15.25%),其中切口感染5例,肺部感染3例,尿路感染1例。感染组与未感染组患者的年龄、是否吸烟、合并慢性阻塞性肺疾病、美国麻醉师协会(ASA)分级、术前与术后白蛋白含量、术前与术后血红蛋白含量、术前与术后第1秒用力呼气容积(FEV1)占预计值百分比、术中出血量、麻醉后监测治疗室(PACU)停留时间、术后引流管拔除时间等的差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,术前和术后低白蛋白水平、术前和术后低血红蛋白水平、术后FEV1占预计值百分比低、PACU停留时间长、术后引流管拔除时间长是胆囊切除术后医院感染的危险因素(P<0.05)。结论:胆囊切除术后医院感染的危险因素包括术前和术后低白蛋白水平、术前和术后低血红蛋白水平、术后FEV1占预计值百分比低、PACU停留时间长、术后引流管拔除时间长。临床应当加强上述危险因素的筛查与管理。

Objective:To explore the risk factors of nosocomial infection after cholecystectomy.Methods:A retrospective study was conducted on 59 cholecystectomy patients who received treatment in Henan Chest Hospital from January 2023 to December 2023.The patients were divided into infected group and uninfected group according to whether nosocomial infection occurred.The general data and treatment of all patients were analyzed.Also the risk factors of nosocomial infection were analyzed.Results:Among the 59 patients,9 cases(15.25%)were nosocomial infection,including 5 cases of incision infection and 1 case of urinary tract infection.There were statistically significant differences between the the infected and uninfected group in age,whether smoke or not,chronic obstructive pulmonary disease,American Society of Anesthesiologists(ASA)scale,preoperative and postoperative hemoglobin content,expected percentage of forced expiratory volume in one second(FEV1)before and after surgery,intraoperative blood loss,standing time in the postanethesia care unit(PACU),and postoperative drainage tube removal time(P<0.05).Multivariate logistic regression analysis showed that low pre-operative and post-operative albumin levels,low pre-operative and post-operative hemoglobin levels,low postoperative FEV1 percentage of predicted value,long PACU stay time and long post-operative drainage tube removal time were risk factors for nosocomial infection after cholecystectomy(P<0.05).Conclusions:Risk factors for nosocomial infection after cholecystectomy include low preoperative and postoperative albumin,low preoperative and postoperative hemoglobin,low postoperative FEV1 percentage of predicted value,long PACU stay time and long postoperative drainage removal time.Clinical screening and management of the above risk factors should be strengthened.