腹部手术部位感染危险因素的病例对照研究  

Risk factors of surgical site infections of abdominal operation in general surgery department: a case-control study

作　　者：林佩贤[1] 黄宝添[2] 王清江[3] 江静静[1] 林伟青[1] 

机构地区：[1]汕头大学医学院第二附属医院医院感染管理科,广东汕头515041 [2]汕头大学医学院附属肿瘤医院放疗科,广东汕头515041 [3]上海市第十人民医院医院医务科,上海200072

出　　处：《中华疾病控制杂志》2015年第11期1145-1148,共4页Chinese Journal of Disease Control & Prevention

基　　金：汕头市医疗科技计划项目(汕府[2014]62号)

摘　　要：目的探讨普外科腹部手术部位感染的危险因素，以及感染引起的经济负担。方法前瞻性调查并随访2012年1月-2013年6月普外科收治并实施腹部手术患者，采用1：3配对病例对照方法进行危险因素的单因素和多因素分析，比较两组的住院时间和费用。结果868例患者中共51例发生手术部位感染（感染率为5．88％），剖腹探查、结直肠手术的感染率最高。回归分析结果示术前存在感染、急诊手术、切口类型、ASA分级、引流、非围术期预防用药为感染的危险因素。与对照组相比，病例组住院时间长，住院费用高，差异均有统计学意义（均有P〈0．05）。结论普外科腹部手术部位感染存在多种危险因素，引起的疾病负担较重。应识别高危人群，针对可控因素采取预防措施，以避免和减少手术部位感染的发生。Objective To explore the risk factors of abdominal surgical site infection（SSI） in general surgery de- partment, and to analyze the burden of disease caused by infection. Methods A prospective study was performed on pa- tients underwent abdominal operation in general surgery department and the patients were followed up post-operation. Cases and controls were matched with a ratio of 1：3 for single and multivariate analysis. Hospitalized time and fee were compared between the two groups. Results A total of 868 patients were investigated and 51 of them and SSI （the infection rate was 5.88% ）. The infection rates were the highest in the patients who underwent laparotomy and colorectal surgery. Preopera- tive infection, emergency operation, surgical wound classification, anesthesia type, drainage and prophylactic drug use dur- ing non perioperative period were risk factors related with abdominal SSI, when screened out with conditional logistic regres- sion. Duration and costs of hospitalization were higher than those of the control group, and the differences were statistically significant （ all P 〈 0. 05 ）. Conclusions There are various factors related to abdominal SSI in general surgery department. SSI results in heavier burden of disease to patients and health care system. It is necessary to identify the high risk group and to take preventive measures according to controllable factors, in order to decrease the occurretlce of SSI effectively.

关 键 词：外科伤口感染 危险因素 腹部 病例对照研究 

分 类 号：R619.3[医药卫生—外科学] R181.2[医药卫生—临床医学]