食管癌患者手术部位感染目标性监测成效分析  

Effects analysis of the targeted surveillance for the surgical site infections in patients with esophageal cancer

作　　者：陈建伟[1] 韩立海[1] 赵爱荣[1] 邱会芬[1] 张洁[1] 孙吉花[1] 

机构地区：[1]滨州医学院附属医院感染管理办公室,山东滨州256603

出　　处：《中华医院感染学杂志》2015年第15期3513-3515,共3页Chinese Journal of Nosocomiology

基　　金：中华医院感染控制研究基金资助项目(ZHYY2014-0027);滨州市科技发展计划基金资助项目(2013ZC1714;2013ZC1802)

摘　　要：目的开展食管癌患者手术部位感染(SSI)目标性监测,了解感染相关危险因素,采取有效干预措施对患者降低SSI率。方法采用前瞻性调查和信息反馈的方法,监测2012年7月-2013年6月食管癌手术患者101例,前3个月监测为评估阶段,作为干预前31例,根据评估所得SSI相关危险因素实施预防控制措施,评价干预后9个月为干预后70例,分析干预效果,采用SPSS17.0进行统计分析。结果 101例食管癌手术患者发生感染7例,感染率6.93%,干预后患者SSI发生率2.86%,明显低于干预前的16.13%(P<0.05);与干预前比较,干预后手术持续时间≥3h的手术抗菌药物的追加使用率明显提高(P<0.01),术后抗菌药物的使用率和联合用药率均明显降低,停药时间提前(P<0.01)。结论食管癌患者SSI率高,与食管吻合口瘘密切相关;通过提高手术技巧、缩短手术持续时间、规范抗菌药物使用,以及严格落实围术期感染控制措施,可以有效降低SSI发生率。OBJECTIVE To investigate the related risk factors for surgical site infections （SSI） in the patients with esophageal cancer by targeted surveillance ,and go further into effective intervention to reduce the incidence rate of SSI .METHODS Prospective survey with feedback of information was performed for all the 101 cases of patients undergoing esophagectomy from Jul .2012 to Jun 2013 .The surveillance of the first three months was regarded as the assessment stage .Totally 31 cases without intervention were used as the control group ,and the 70 cases who had been intervened for last nine months were treated as the intervention group .The interventions were made ac‐cording to the related risk factors been monitored from the control group ,and the evaluation was obtained by com‐pairing the monitoring information from the two groups .All data were cally analyzed by SPSS 17 .0 software . RESULTS The totally incidence rate of SSI was 6 .93% ,7 infected cases of the 101 patients .SSI rate of 2 .86% in the intervention group was significantly lower than that of 16 .13% in the control group （P〈0 .05） .After inter‐vention ,perioperative prophylactic use of antibiotics was more standardized ,the additional usage rate of antibiotics was higher if operation continues more than 3 hours ,the usage rate of postoperative antibiotics and the rate of com‐bined antibiotics were significantly lower （P〈0 .01） ,furthermore the withdrawal time of postoperative antibiotics was earlier（P〈0 .01） .CONCLUSION The incidence rate of SSI in the patients with esophageal cancer is high , closely associated with anastomotic fistula ,and that can be effiectively reduced by improving surgical skills ,short‐ening the persistence of operation time ,standardizing antibiotics and strictly implementation of perioperative infec‐tion control measures .

关 键 词：食管癌 手术部位感染 目标性监测 

分 类 号：R619.3[医药卫生—外科学]