肛肠疾病肛周手术切口感染诊断标准的建立与评估  

Establishment and Evaluation of the Diagnostic Standards for Perianal Wound Infection of Anorectal Diseases

作　　者：梁建生[1] 罗俊[1] 徐桂兰[1] 邓兵[1] 林国南[1] 俞立民 王燕 吴凯 汪洋[4] 刘杏桃 黄卉 向玉燕[7] 

机构地区：[1]湖北省武汉市疾病预防控制中心,湖北武汉430015 [2]湖北省武汉市第八医院 [3]湖北省武汉市江岸区疾病预防控制中心 [4]湖北省武汉市第一医院 [5]湖北省武汉市第五医院 [6]湖北省武汉市东西湖区人民医院 [7]科中科技大学同济医学院附属同济医院

出　　处：《中国肛肠病杂志》2009年第6期21-24,共4页Chinese Journal of Coloproctology

基　　金：武汉市医学卫生科技计划项目（2003-10）

摘　　要：为探讨、建立肛肠疾病肛周手术切口感染诊断标准，在无金标准情况下进行诊断试验方法及感染率、灵敏度、特异性的估计，我们采用流行病学前瞻性调查方法在武汉市不同规模的5家医院调查、收集资料，采取聚类分析法对术后切口部位主要症状指征进行相关性分析，建立新的诊断标准，并将新建的《肛肠疾病肛周切口医院感染诊断标准》与卫生部《医院感染诊断标准（试行）》（2001）中的“深部切口感染诊断标准”进行对比、评估。结果显示，新建诊断标准与卫生部现行的诊断标准比较，新建诊断标准的灵敏度、特异性分别为89．36％和86．43％；两种诊断标准经一致性检验（Kappa=0．70，P=0．04〈0．05），有统计学意义。结果表明，与卫生部现行的“深部切口感染诊断标准”比较，新建的诊断标准灵敏度高、特异性强，两种诊断标准的一致性较好，表明新建的《肛肠疾病肛周切口医院感染诊断标准》能达到临床应用水准。为其他污染手术切口感染的诊断与监测提供了适宜、科学的参考标准和方法。To establish and evaluate the diagnostic standards for perianal wound infection of anorectal diseases, under the condition of no golden standard, diagnostic methods were set up and infection rate, sensitivity and specificity were evaluated on the basis of the new methods. Data about the main symptoms status of the postoperative perianal wound cases from five hospitals of different level in Wuhan city were collected and analized with cluster analysis. Besides,our《the Diagnostic Standards for Perianal Wound Infection of Anorectal Diseases》 were compared and evaluated with ＂diagnostic standard of deep incision infection＂ of 《the Diagnostic Standards for Hospital Infections》（ for trial implementation, 2001） issued by the Ministry of Health. As results, the sensitivity and specificity of our diagnostic standard compared with that issued by the Ministry of Health was 89.36% and 86.43% respectively; the consistency test of the two standards revealed that there was statistical significance（ Kappa =0. 70, P =0. 04〈0.05）. It is concluded that our diagnostic standards have more sensitivity and specificity compared with that issued by the Ministry of Health, the two diagnostic standards are well identical, and our standards is clinically feasible. In brief, our diagnostic standards can be served as a necessary and proper reference standard for the diagnosis and monitoring of other surgical incision infection.

关 键 词：肛肠疾病 切口感染 诊断标准 聚类分析法 一致性检验 

分 类 号：R619.3[医药卫生—外科学] R446.62[医药卫生—临床医学]