外科患者围手术期输血与感染的病原学调查  

Perioperative blood transfusion of surgery pationts and etiological analysis of infections

作　　者：陈碧乐[1] 赵秘胜 郭瑞德[1] 

机构地区：[1]温州医学院附属第一医院输血科,浙江温州325000 [2]温州市人民医院检验科,浙江温州325000

出　　处：《中华医院感染学杂志》2013年第19期4676-4677,4691,共3页Chinese Journal of Nosocomiology

基　　金：温州市科技局科研基金(Y20100097)

摘　　要：目的了解外科患者围手术期输入同种异体血与术后感染的病原学调查,加强感染监控,防止由于输血导致的免疫力低下所致的感染发生。方法回顾性调查医院2012年1-6月外科围手术期输血患者502例临床资料,术后伤口感染依据外科切口感染的标准进行诊断。结果 502例围手术期输血患者细菌培养阳性76例感染率为15.14%;26例发生切口感染占34.21%,12例发生血流感染占15.79%;18例发生术后腹、盆腔深部组织感染占23.69%;6例患者发生导管相关性感染占7.89%;6例患者发生肺部感染占7.89%,5例发生泌尿道感染占6.58%;共检出病原菌89株,其中革兰阳性菌35株占39.33%,革兰阴性菌39株占43.82%,真菌15株占16.85%。结论围手术期输血是导致术后感染率增高,其感染的主要病原菌是大肠埃希菌。OBJECTIVE To investigate the pathogens causing postoperative infections in the patients with surgery and perioperative blood transfusion, strengthen infection control, and prevent the infections due to transfusion- related poor immunity. METHODS The prevalence of postoperative infections among 502 patients with surgery and blood transfusion was investigated retrospectively from Jan 2012 to Jun 2012. RESULTS After the patients were subjected to blood transfusion, 76 of 502 patients （15. 14%） were found to acquire nosocomial infections. Infection of incisional wound was found to be the most frequently encountered infections （34.21%）, followed by infections of cavitas pelvis and belly（23. 69% 18/76）, bloodstream infections （15. 79%）, catheter-related infections（7. 89%, 6/76）, pulmonary infections （7. 89%, 6/76） and urinary tract infections （6. 58%）. 89 pathogenic strains were detected, including 35 strains of gram-positive bacteria （39.33%）, 39 strains of gram- negative bacteria （43.82 ~）, and 15 strains of fungi （16.85 %）. CONCLUSION A relatively high prevalence of postoperative infections is found in the patients with surgery and blood transfusion. E. coli is the most prevalent pathogen.

关 键 词：病原菌 围手术期 输血 感染 

分 类 号：R181.32[医药卫生—流行病学]