骨科患者手术部位感染目标性监测及危险因素分析  

Targeted monitoring of surgical site infections in patients of department of orthopedics and analysis of risk factors

作　　者：王飞[1] 张秀月[1] 万书[1] 齐月[1] 施红[1] 

机构地区：[1]中国医科大学附属盛京医院医院感染管理办公室,辽宁沈阳110004

出　　处：《中华医院感染学杂志》2014年第21期5355-5356,5370,共3页Chinese Journal of Nosocomiology

基　　金：中华医学会基金资助项目(09-977);辽宁省自然科学基金资助项目(20102284)

摘　　要：目的对骨科手术开展目标性监测,了解手术部位感染率,分析感染有关危险因素,制定合理预防控制措施,有效减少感染发生。方法前瞻性调查2013年5月-2014年2月骨科全部手术患者530例,包括临床资料、生活方式、入院及手术相关信息,监测手术部位感染发生情况;采用SPSS16.0软件对数据进行统计分析。结果530例手术患者中3例发生手术部位感染,感染率为0.57%;通过单因素分析发现,手术部位感染与骨折入院、伴有风湿性关节炎、糖尿病、心脏病、高血压及慢性阻塞性肺疾病(COPD)、术前外周血白细胞(WBC)值、手术持续时间、术者职称、引流管留置天数、术中使用抗菌药物和住院天数有关(P<0.05),而与BMI指数、术前发热、手术类型、ASA麻醉分级等因素无关;多因素logistic回归分析表明,住院天数≥30d、伴有风湿性关节炎、糖尿病、心脏病、高血压及COPD、术前外周血WBC高等7个因素是手术部位感染的独立危险因素。结论开展目标性监测可明确手术部位感染率和危险因素,为骨科预防控制感染提供数据支持和理论依据。OBJECTIVE To conduct the targeted monitoring in the orthopedics department ,understand the inci-dence of surgical site infection ,analyze the related risk factors ,and put forward appropriate prevention measures so as to effectively reduce the incidence of infections .METHODS The prospective survey was conducted for 530 pa-tients who underwent surgeries in the department of orthopedics from May 2013 to Feb 2014 ,including the clinical data ,lifestyle ,admission to hospital ,and relevant information of surgeries ;the incidence of surgical site infec-tions was monitored ;the statistical analysis was performed by using SPSS16 .0 software .RESULTS Of the 530 pa-tients investigated ,the surgical site infections occurred in 3 cases with the infection rate of 0 .57% .The univariate analysis showed that the incidence of surgical site infections was associated with the admission to hospital due to fracture ,complication of rheumatoid arthritis ,diabetic mellitus ,heart disease ,hypertension ,or COPD ,preopera-tive WBC counts in peripheral blood ,operation duration ,title of surgeon ,catheter indwelling duration ,intraoper-ative use of antibiotics ,and hospitalization duration （P〈0 .05） ,but it was not related to the body mass index （BMI） ,preoperative fever ,type of surgery ,or ASA classification .The multivariate logistic regression analysis indicated that the hospitalization duration no less than 30 days ,complication of rheumatoid arthritis ,diabetic mel-litus ,heart disease ,hypertension ,and COPD as well as the high level of WBC in peripheral blood were the seven independent risk factors for the surgical site infections .CONCLUSION The incidence of surgical site infections and the risk factors can be defined through conduct of the targeted monitoring ,which can provide supportive data and theoretical basis for prevention of the infections in the orthopedics department .

关 键 词：骨科手术 手术部位感染 危险因素 目标性监测 

分 类 号：R619.3[医药卫生—外科学]