产妇会阴部手术切口感染危险因素与病原菌分析  

Risk factors for perineal incision infections in puerpera and distribution of pathogens

作　　者：张敏[1] 罗云[1] 周军[1] 西慧芳[1] 李延华[1] 

机构地区：[1]山东省千佛山医院产科,山东济南250014

出　　处：《中华医院感染学杂志》2015年第12期2851-2853,共3页Chinese Journal of Nosocomiology

基　　金：山东省科技发展计划基金资助项目(2013G0021814)

摘　　要：目的探讨产妇会阴部手术切口感染危险因素及病原菌分布,为切口感染的预防治疗提供依据。方法回顾性分析2014年1月-2015年1月在医院足月分娩行会阴侧切的500例产妇临床资料,记录切口感染发生率、病原菌分布;调查产妇的临床资料,统计分析导致会阴切口感染的独立危险因素。结果 500例产妇中共有12例发生切口感染,感染率为2.4%;切口感染产妇送检标本分离出37株病原菌,其中革兰阴性菌13株占35.1%,革兰阳性菌21株占56.8%,真菌3株占8.1%;单因素分析显示,年龄>30岁、体质量指数>30kg/m2、合并基础疾病及孕期并发症、产后住院时间>5d、未预防性使用抗菌药物的产妇手术切口感染率显著上升,差异有统计学意义(P<0.05);多因素分析结果显示,体质量指数、基础疾病、产后住院时间、预防性抗菌药物是导致手术切口的独立危险因素。结论会阴切口感染病原菌主要为革兰阳性菌;控制影响切口感染危险因素是降低术后感染的主要措施。OBJECTIVE To explore the risk factors for perineal incision infections in the puerpera and observe the distribution of pathogens so as to provide guidance for prevention and treatment of the incision infections . METHODS The clinical data of 500 puerpera who gave the term birth through lateral episiotomy from Jan 2014 to Jan 2015 were retrospectively analyzed ,then the incidence of incision infections and distribution of pathogens were recorded ,the clinical data of the puerpera were investigated ,and the independent risk factors for the perineal inci‐sion infections were statistically analyzed .RESULTS The incision infections occurred in 12 of 500 puerpera ,with the infection rate of 2 .4% .A total of 37 strains of pathogens have been isolated from the submitted specimens ob‐tained from the puerpera with incision infections ,including 13 （35 .1% ） strains of gram‐negative bacteria ,21 （56 .8% ） strains of gram‐positive bacteria ,and 3 （8 .1% ） strains of fungi .The univariate analysis indicated that the incidence of surgical incision infections was significantly increased in the puerpera with the more than 30 years of age ,body mass index more than 30 kg/m2 ,complication of underlying disease ,pregnancy complications ,or postpartum length of hospital stay more than 5 days ,or without antibiotics prophylaxis ,and the difference was statistically significant （P〈0 .05） .The multivariate analysis showed that the body mass index ,underlying dis‐ease ,postpartum length of hospital stay ,and antibiotics prophylaxis were the independent risk factors for the sur‐gical incision infections .CONCLUSION The gram‐positive bacteria are dominant among the pathogens causing the perineal incision infections .It is the key to the control the risk factors so as to reduce the incidence of the postop‐erative incision infections .

关 键 词：会阴切口 病原菌 危险因素 分娩 

分 类 号：R619.3[医药卫生—外科学]