冠状动脉搭桥术患者手术部位感染聚集性调查研究  

Investigation of clustering events of surgical site infections in patients undergoing coronary artery bypass grafting

作　　者：程丽峰[1] 阿依古丽[1] 朱敏[1] 卢辉[1] 魏育涛[2] 

机构地区：[1]新疆生产建设兵团第一师医院感染办,新疆阿克苏843000 [2]石河子大学医学院一附院心胸外科,新疆石河子832008

出　　处：《中华医院感染学杂志》2015年第11期2545-2547,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81460059)

摘　　要：目的调查医院心胸外科病房手术部位感染聚集性事件发生的高危因素,为预防与控制医院感染提供参考依据。方法对2012年7-8月医院心胸外科发生的疑似手术切口感染病例开展流行病学调查,并对相关高危因素进行分析,采取综合性干预控制措施,避免医院感染的扩散。结果 2012年7-8月医院心胸外科冠状动脉搭桥术患者8例,发生手术部位感染4例,感染率为50.00%;4例冠状动脉搭桥术感染患者基础疾病较重,3例伴有糖尿病,手术方式复杂、持续时间长,手术切口感染症状相同,均出现红、肿、热、痛,有血性分泌物,同时伴有切口裂开,创面分泌物培养无细菌生长;但调查过程中发现,医务人员手卫生和物体表面清洁不到位,环境卫生学监测均分离到金黄色葡萄球菌,手术部位医院感染暴发不能完全排除,考虑为手术部位感染聚集性事件,经积极治疗4例患者相继治愈出院。结论通过强化医院感染预防控制意识,采取迅速及时和有针对性的预防控制措施,可以有效控制医院感染聚集性事件的发生。OBJECTIVE To investigate the high risk factors for clustering events of surgical site infections in wards of cardiothoracic surgery department so as to provide guidance for prevention and control of nosocomial infections . METHODS The epidemiological survey was conducted for the patients with suspected surgical site infections who were treated in the cardiothoracic surgery department from Jul to Aug ,2012 ,the high risk factors were analyzed , and the comprehensive interventions were taken to avoid the spread of nosocomial infections .RESULTS The surgical site infections occurred in 4 of 8 patients who underwent the coronary artery bypass grafting in the cardiothoracic surgery department ,with the infection rate of 50 .00% .All the 4 cases were complicated with se‐vere underlying diseases ,and 3 cases were complicated with diabetic mellitus ;the surgical procedures were complex ,the operation duration was long ,and the symptoms of surgical incision infections were the same ,all the cases had the redness ,swelling ,heat ,and bloody discharge ,accompanied by incision dehiscence ,and the culture of wound secretions showed that there was no growth of bacteria .The hand hygiene of the health care workers and the cleaning of object surfaces were unqualified ,the environmental hygiene surveillance indicated that the Staphy‐lococcus aureus have been isolated , the outbreak of the surgical site infections could not completely excluded , which was defined as the clustering events of surgical site infections ,and the 4 patients were cured and discharged successively after the active treatment .CONCLUSION It is an effective way to intensify the consciousness of control of the nosocomial infections and take targeted prevention measures so as to control the clustering events of nosocomial infections .

关 键 词：手术部位感染 冠状动脉搭桥术 聚集性事件 调查 

分 类 号：R619.3[医药卫生—外科学]