会阴侧切初产妇切口感染的病原菌分布和危险因素分析

Distribution of pathogens and risk factors of incision infection in primipara undergoing lateral perineal incision

目的探讨会阴侧切初产妇切口感染的病原菌分布情况和危险因素。方法以2015年6月至2018年6月入院行会阴侧切自然分娩的1 198名初产妇为研究对象,回顾性分析其临床资料。结果 1 198名行会阴侧切的初产妇中,有92名产妇在会阴侧切术后发生切口感染,其切口感染的发生率为7. 68%;92名发生切口感染的会阴侧切初产妇中,通过分离培养出165株病原菌,其中革兰阴性菌所占的比例最高,共有106株(占64. 24%);多因素Logistic回归分析结果显示,体质指数≥28 kg/m2、年龄≥35岁、阴道或肛门检查次数≥4次、合并妊娠期糖尿病、胎膜早破和生殖道感染是导致会阴侧切初产妇切口感染的独立危险因素(OR> 1,P <0. 05)。结论会阴侧切初产妇切口感染的发生率较高,革兰阴性菌为主要的病原菌,其相关危险因素较多,应引起我们的关注。

Objective To investigate distribution of pathogens and risk factors of incision infection in primipara undergoing lateral perineal incision.Methods The clinical data of 1 198 primipara who were admitted to our hospital from June 2015 to June 2018 were retrospectively analyzed.Results Among 1 198 primipara undergoing lateral perineal incision,92 cases had incision infection after lateral perineal incision,and the incidence of incision infection was 7.68%.Among 92 primipara undergoing lateral perineal incision,165 pathogenic bacteria were isolated and cultured,of which 106 were Gram-negative bacteria(6.68%).Multivariate logistic regression analysis showed that body mass index>28 kg/m2,age>35 years,number of vaginal or anal examinations>4,complication with gestational diabetes mellitus,premature rupture of membranes and genital tract infection were independent risk factors for incision infection in primipara undergoing lateral perineal incision(OR>1,P<0.05).Conclusion The incision infection rate of primipara with lateral perineal incision is comparatively higher.Gram-negative bacteria are the main pathogens,and there are many risk factors,which should be paid attention to.