肝胆外科手术患者医院感染的相关因素分析  

Risk factors for nosocomial infections in patients of hepatobiliary surgery department

作　　者：陈梅先[1] 元云飞[1] 陈盈[1] 黄佳燕[1] 吴剑辉[2] 

机构地区：[1]华南肿瘤学重点实验室中山大学肿瘤防治中心肝胆科,广东广州510060 [2]华南肿瘤学重点实验室中山大学肿瘤防治中心护理部,广东广州510060

出　　处：《中华医院感染学杂志》2014年第1期144-145,153,共3页Chinese Journal of Nosocomiology

基　　金：广东省高等学校科技创新重点基金项目(CXZD1133)

摘　　要：目的分析肝胆外科手术患者医院感染的相关危险因素,为临床选择有针对性的防治措施提供参考。方法回顾性分析1 400例肝胆外科行手术治疗患者的临床资料,依据是否并发医院感染将患者分为感染组和未感染组,比较两组患者术前吸烟史、既往慢性呼吸道疾病史、既往糖尿病史、术前低蛋白血症、术前住院时间、手术时间、气管插管时间、呼吸机使用时间、留置鼻胃管时间等指标。结果肝胆外科手术患者术后并发医院感染率为4.29%,感染组中吸烟患者、慢性呼吸道疾病史患者及术前低蛋白血症患者分别占48.33%、53.33%和23.33%,未感染组分别占13.43%、9.78%和10.82%,两组比较差异均有统计学意义(P<0.05);感染组患者术前住院时间、手术时间、气管插管时间、呼吸机使用时间以及留置鼻胃管时间分别为(5.53±1.29)d、(154.28±30.28)min、(128.31±12.36)min、(3.01±1.21)min和(7.28±2.18)d,未感染组分别为(3.01±1.12)d、(118.36±23.40)min、(89.16±10.14)min、(1.28±0.39)min、(5.13±1.78)d,两组比较差异均有统计学意义(P<0.05)。结论吸烟史、慢性呼吸道疾病史、术前低蛋白血症、术前住院时间较长、手术时间较长、术中气管插管时间较长、使用呼吸机和术后长时间留置鼻胃管均是肝胆外科手术患者医院感染发生的相关因素。OBJECTIVE To analyze the risk factors for nosocomial infections in the patients of hepatobiliary surgery department so as to put forward targeted prevention measures.METHODS The clinical data of 1400patients undergoing surgery in the hepatobiliary surgery department were retrospectively analyzed,then the subjects were divided into the infection group and the non-infection group according to the infection status,and the preoperative smoking history,diabetes history,preoperative hypoalbuminemia,preoperative hospitalization duration,operation duration,endotracheal intubation time,duration of use of ventilator,and nasogastric catheter indwelling time were observed and compared between the two groups.RESULTS The incidence of the postoperative nosocomial infections was 4.29% in the patients of hepatobiliary surgery department.The patients with smoking history accounted for 48.33% in the infection group,13.43% in the non-infection group;the patients with history of chronic respiratory tract disease accounted for 53.33% in the infection group,9.78% in the non-infection group;the patients with preoperative hypoalbuminemia accounted for 23.33% in the infection group,10.82% in the non-infection group,the differences between the two groups were significant（P0.05）.The preoperative hospitalization duration was（5.53±1.29）days in the infection group,（3.01±1.12）days in the non-infection group;the operation duration was（154.28±30.28）min in the infection group,（118.36±23.40）min in the non-infection group;the endotracheal intubation time was（128.31±12.36）min in the infection group,（89.16±10.14）min in the non-infection group;the duration of use of ventilator was（3.01±1.21）min in the infection group,（1.28±0.39）min in the non-infection group;the nasogastric catheter indwelling time was（7.28±2.18）days in the infection group,（5.13±1.78）days in the non-infection group,the differences between the two groups were significant（P 0.05）.CONCLUSIONThe smoking history,chronic respiratory t

关 键 词：肝胆外科 手术 医院感染 危险因素 

分 类 号：R181.32[医药卫生—流行病学]