外科手术患者切口感染的相关因素分析及对策  

Related factors for surgical incision infections and prevention countermeasures

作　　者：申玉琴[1] 宋百灵[1] 梁怡虹[1] 

机构地区：[1]日照市人民医院手术室,山东日照276826

出　　处：《中华医院感染学杂志》2014年第1期141-143,共3页Chinese Journal of Nosocomiology

基　　金：山东省日照市科协基金资助项目(2012-246)

摘　　要：目的探讨外科手术患者发生切口感染的相关影响因素,以降低感染率。方法随机选取2011年1月-2013年1月285例手术患者临床资料,对所有患者相关资料进行调查,如手术类型、手术地点、手术部位、手术时间、参与人员、术前用药、麻醉方式等进行汇总和分析,采用SPSS13.0软件进行统计分析,采用logistic多因素从单因素中进行危险因素分析。结果 285例手术患者,发生切口感染31例,感染率为10.9%,前3位感染因素依次为手术室参观人员>3人、Ⅲ类切口感染、无菌操作不到位,感染率分别为41.9%、35.5%、32.8%;影响外科切口感染相关单因素有非层流手术室、参观人员多(>3人)、手术时间长(>4h)、手术结台、Ⅲ类切口类型、外来手术器械、无菌操作不规范、术中隔离不严格、术中未应用抗菌药物、皮肤消毒不严格、患者免疫力低下、侵入性操作、空气菌落多(≥500CFU/m3)、医疗废物未处理(P<0.05),其中非层流室、接台手术、手卫生消毒、手术时间、切口类型是外科切口感染的相关高危因素。结论在手术室中要采取一切措施尽可能降低外科手术切口感染的发生。OBJECTIVE To explore the related factors for surgical incision infections so as to reduce the infection rate.METHODS The clinical data of 285 patients who underwent surgery from Jan 2011 to Jan 2013were randomly collected,then the types of surgery,location of surgery,surgical sites,operation duration,participants,preoperative medication,and anesthesia were summarized and analyzed,the statistical analysis was performed with the use of SPSS13.0 software,and the multivariate logistic regression analysis of the risk factors was conducted. RESULTS Of totally 285 patients investigated,the incision infections occurred in 31 cases with the infection rate of 10.9%;the incidence rate of the incision infections was 41.9% due to the visits to the operating rooms more than 3people,35.5% due to the typeⅢincision,32.8% due to the inappropriate aseptic operation.The univariate analysis showed that the influencing factors for the incision infections included the non-laminar flow operating rooms,frequent visits to the operating rooms（more than 3 people）,long operation duration（more than 4hours）, consecutive surgery,typeⅢincision,foreign surgical instruments,substandard aseptic operation,loose intraoperative isolation,without intraoperative use of antibiotics,loose skin disinfection,low immunity,invasive operation,bacterial colony counts in air colony more than 500CFU/m3,and without disposal of medical waste（P 0.05）,among which the non-laminar flow operating rooms,consecutive surgery,hand hygiene,operation duration,and types of incision were the high risk factors for the surgical incision infections.CONCLUSIONIt is necessary to take all potential measures to reduce the incidence of surgical incision infections in the operating rooms.

关 键 词：外科手术 切口感染 手术室 影响因素 对策 

分 类 号：R619.3[医药卫生—外科学]