宫腔镜手术后患者医院感染的危险因素分析  

Risk factors for postoperative nosocomial infections in patients undergoing hysteroscopic surgery

作　　者：彭凌[1] 孙涛[1] 赵赢[1] 王秋菊[1] 邓瑶[1] 

机构地区：[1]首都医科大学附属北京妇产医院计划生育科,北京100006

出　　处：《中华医院感染学杂志》2015年第10期2370-2372,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(1200320306)

摘　　要：目的探讨宫腔镜手术后患者合并医院感染及相关因素,为降低宫腔镜术后医院感染的发生提供依据。方法选取2009年1月-2014年11月医院89 037例行宫腔镜手术治疗患者,对术后发生医院感染患者的临床资料进行统计分析,分析其感染特点及其相关危险因素、主要致病菌,探讨预防医院感染的有效方法及护理措施。结果 89 037例宫腔镜手术患者术后感染88例,感染率为0.10%,感染类型以子宫内膜炎为主,占69.32%,其次为子宫肌内膜炎和盆腔炎,分别占15.91%和7.95%;共检出病原菌150株,前4位病原菌依次为链球菌属、大肠埃希菌、葡萄球菌属、肠球菌属,分别占30.67%、22.00%、16.67%、14.00%;宫腔镜手术后患者年龄、体质量指数、手术时间、手术等级、子宫大小、术前炎症、预防应用抗菌药物为宫腔镜手术后患者医院感染相关因素(P<0.05)。结论导致宫腔镜手术后医院感染相关危险因素较多,患者伴有合并症、术前存在炎症、手术等级高及子宫肌壁的损伤严重均提高了宫腔镜手术后医院感染率,在治疗护理过程中应严格控制无菌,加强器械消毒,预防性使用抗菌药物,以便预防或降低医院感染的发生率。OBJECTIVE To investigate the prevalence of postoperative nosocomial infections in patients undergoing hysteroscopic surgery and analyze the related factors so as to provide guidance for reduction of incidence of the postoperative nosocomial infections .METHODS A total of 89 037 patients who underwent the hysteroscopic sur‐gery from Jan 2009 to Nov 2014 were enrolled in the study ,then the clinical data of the patients with postoperative nosocomial infections were statistically analyzed ,the characteristics and related risk factors for the infections were analyzed ,the distribution of the main pathogenic bacteria was observed ,and the effective nursing measures were put forward to prevent the nosocomial infections .RESULTS The postoperative infections occurred in 88 of 89 037 patients undergoing hysteroscopic surgery ,with the infection rate of 0 .10% .Among the patients with postopera‐tive infections ,69 .32% had endometritis ,15 .91% had intramuscular uterus meningitis ,and 7 .95% had pelvic in‐flammation .Totally 150 strains of pathogens have been isolated;the Streptococcus spp ,Escherichiacoli ,Staphy‐lococcus sp p ,and Enterococcus sp p ranked the top 4 species ,accounting for 30 .67% ,22 .00% ,16 .67% ,and 14 .00% ,respectively .The related factors for the postoperative nosocomial infections in the patients undergoing hysteroscopic surgery included the age ,body mass index ,operation duration ,types of surgery ,size of uterus , preoperative inflammation ,and prophylactic use of antibiotics （P〈 0 .05） .CONCLUSION There are a variety of risk factors for the postoperative nosocomial infections in the patients undergoing the hysteroscopic surgery .The complications ,preoperative inflammation ,high surgical grade ,and severe damage of uterine muscle wall may in‐crease the risk of the postoperative nosocomial infections .It is necessary to conduct strict aseptic operation , strengthen the disinfection of instruments ,and carry out the antibiotic prophylaxis so as to reduce the incidence of nosocomi

关 键 词：宫腔镜手术 医院感染 危险因素 妇科 

分 类 号：R619.3[医药卫生—外科学]