结直肠切除手术部位感染的目标性监测与危险因素分析  

Targeted Surveillance and Risk Factors Analysis on Surgical Site Infection after Colorectal Resections

作　　者：李诗雨[1] 黄文治[1] 乔甫[1] 李明霞[2] 尹维佳[1] 

机构地区：[1]四川大学华西医院医院感染管理科,成都610041 [2]四川大学华西医院胃肠中心二病区,成都610041

出　　处：《华西医学》2015年第6期1105-1108,共4页West China Medical Journal

摘　　要：目的探讨结直肠手术患者术后发生手术部位感染的危险因素,为制定并实施手术部位感染预防措施提供依据。方法对2012年2月-12月行"结肠切除"和"直肠切除"的手术患者实施手术部位感染目标性监测,并对监测资料进行分析,探讨术后发生手术部位感染的情况,同时通过病例对照研究,分别对高血压、糖尿病、手术持续时间、美国麻醉医师协会评分、切口等级评分等12个变量进行单因素和多元logistic回归分析,系统分析发生手术部位感染的危险因素。结果研究期间共监测结直肠手术患者535例,其中发生手术部位感染44例,结、直肠术后手术部位感染率为8.22%;多元logistic回归结果显示住院时间长[OR=1.070,95%CI(1.033,1.109),P<0.001]和行急诊手术者[OR=6.320,95%CI(1.932,20.669),P=0.002]是结直肠手术部位感染的独立危险因素。结论结直肠手术发生手术部位感染存在多种危险因素,通过实施目标性监测能发现主要危险因素,为制定并实施干预措施提供依据,最终达到降低手术部位感染率的目的。Objective To investigate the risk factors for surgical site infection （SSI） in patients after colorectal surgery, in order to provide a basis for regulation and implementation of preventive measures against SSI. Methods From February to December 2012, a targeted surveiUance on surgical site infection of ＂colon resection＂ and ＂rectum resection＂ surgery patients in the Department of Gastrointestinal Surgery was carried out. We analyzed the monitoring data, and explored the occurrence of postoperative SSI. At the same time, by case-control study, both single and multiple regression logistic analyses were performed on the 12 variables such as hypertension, diabetes mellitus duration during operation, America Society of Anesthesiologists score, grade of incision and so on to analyze the risk factors for SSI. Results Among the 535 patients who underwent colorectal resections, 44 had SSI with an infection rate of 8.22%. Multiple logistic regression analysis showed that the length of hospital stay [OR=1.070, 95%CI （1.033, 1.109）, P 〈 0.001]and emergency surgery[OR=6.320, 95%CI （1.932, 20.669）, P=0.002] were independent risk factors for SSI after colorectal resections. Conclusions There are many risk factors for SSI after colorectal surgery. Through the implementation of targeted surveillance, we can find the main risk factors, which provides a basis for the regulation and implementation of intervention measures against SSI.

关 键 词：结直肠手术 目标性监测 手术部位感染 危险因素 

分 类 号：R656[医药卫生—外科学]