胃肠外科手术切口感染的高危因素分析及干预对策研究  

Risk Factors for Incision Infection in Gastrointestinal Surgery and Its Preventive Measures

作　　者：韩芳[1] 孟塬[1] 龚国杰[1] 赵兵[1] 

机构地区：[1]新疆维吾尔自治区人民医院北院普外科,乌鲁木齐830054

出　　处：《华西医学》2013年第11期1665-1667,共3页West China Medical Journal

摘　　要：目的分析胃肠外科手术切口感染的影响因素,为医院感染的防治提供理论依据。方法回顾性分析2010年12月-2012年12月764例行胃肠外科手术患者的临床资料,并用单因素χ2检验统计分析患者医院感染的危险因素。结果共有65例患者发生手术切口感染,其感染率为8.5%,且分离培养出合格菌株48株,阳性率73.8%,其中G菌32株,占66.7%,G+菌16株,占33.3%。G菌主要以大肠杆菌、变形杆菌、克雷伯杆菌和肠杆菌为主,分别占29.2%、18.8%、12.5%和6.2%;G+菌以肠球菌和表皮葡萄球菌为主,分别占22.9%和10.4%。单因素χ2检验显示年龄>60岁、手术时间>120 min、术中有输血、且有肿瘤病变的患者具有较高的切口感染发生率(P<0.05)。结论胃肠外科手术切口感染的主要致病菌是G杆菌,患者的年龄、手术时间、术中输血情况和疾病良恶性质是术后切口感染的高危因素,积极采取相应的预防措施有望减低其感染的发生率。Objective To investigate the risk factors for incision infection in gastrointestinal surgery and explore its preventive measures. Methods A total of 764 patients underwent gastrointestinal surgery in our hospital from December 2010 to December 2012, and their clinical data were retrospectively investigated. The risk factors for incision infection were analyzed by Z2 analysis. Results There were 65 cases of incision infection among all the 764 patients. The rate of incision infection in gastrointestinal surgery was 8.5%. In the 65 cases of incision infection, 48 types of bacteria were detected in our hospital with a rate of 73.8%. The types of bacterial included 32 strains of Gram-negative bacteria （accounting for 66.7%） and 16 strains of Gram-positive bacteria （accounting for 33.3%）. Gram-negative bacteria mainly were Escherichia coli, Proteus mirabilis, Klebsiella and Enterobacter which accounted for 29.2%, 18.8%, 12.5% and 6.2%, respectively. Gram- positive bacteria mainly included Enterococci and Staphylococcus epidermidis, and they accounted for 22.9% and 10.4%, respectively. The Z2 analysis showed that age （ 〉 60 years）, operative time （ 〉 120 min）, blood transfusion, and tumor were the risk factors of incision infection in gastrointestinal surgery （P 〈 0.05）. Conclusions The pathogens of incision infection are mainly gram-negative bacilli in gastrointestinal surgery. Patients＇ age, operative time, blood transfusion, and malignant lesions are the main risk factors for incision infection. Taking appropriate preventive measures can help to reduce the incidence of incision infection in gastrointestinal surgery.

关 键 词：胃肠外科 切口感染 医院感染 危险因素 预防措施 

分 类 号：R656.6[医药卫生—外科学]