心脏起搏术后感染及其危险因素的研究  

The study of the postoperative infections and risk factors of the patients undergoing cardiac pacemaker implantation

作　　者：范秋萍[1] 张会芹[1] 李改焕[1] 吴亚杰[1] 

机构地区：[1]河南医科大学第一附属医院

出　　处：《中华医院感染学杂志》1997年第2期75-78,共4页Chinese Journal of Nosocomiology

摘　　要：对某医院接受医院心脏起搏术治疗的２６６例重症缓慢性心律失常患者，进行起搏术后感染及其危险因素的调查，起搏术后感染６９例，感染率为２５．９４％，其中导管切口感染２５例，感染率９．４０％，皮囊切口感染２２例，感染率８．２７％。对调查的１５个因素进行单因素分析，术前住院天数、本次住院接受手术次数、消毒措施、暴露于ＣＣＵ、机器产地、植入方式、术中切口抗生素冲洗、术后预防用抗生素、易感因素与术后感染的发生有显著的联系。通过逐步回归分析，筛选出了４个与起搏术后感染有显著联系的因素：预防用抗生素、消毒措施、暴露于ＣＣＵ、植入方式。其中预防用抗生素种类多、暴露于ＣＣＵ均增加术后感染的危险性；而消毒措施、植入方式与术后感染呈负相关。In this paper, the postoperative infections and risk factors of 266 severe bradyarrhythmia patients who have undergone cardiac pacemaker implantation were investigated in a hospital. Of the 266 patients, 69 patients had postoperative infections (the infection rate was 25.94%), in which 25 cases developed catheter incisional infection and 22 cases had skin-pocket incisional infection (the infection rates were 9. 40% and 8.27% raspectively). Univasate analysis for 15 risk factors was adopted and it was found that the infections were significantly associated with the preoperative days in the hospital, operation numbers, disinfecting measures, exposure hospital, operation numbers, disinfecting measures, exposure to CCU, machine type, implantation way of it, washing incision with antibiotic during operation, antibiotic prophylaxis after operation, etc. By using stepwise regression analysis, 4 variables significantly associated with infections were screened. They were antibiotic prophylaxis after operation, disinfecting measures, exposure to CCU and placed way of machine. Antibiotic prophylaxis and exposure to CCU were directly associated with infections, however, disinfecting measures and placed way of machine were inversely associated with infections.

关 键 词：心脏起搏术 手术后感染 危险因素 

分 类 号：R654.206[医药卫生—外科学] R619.3[医药卫生—临床医学]