根本原因分析法对胃肠手术患者切口感染的预防效果研究  

Effect of root cause analysis on prevention of incision infections in patients undergoing gastrointestinal surgery

作　　者：沈春林[1] 蔡谋善[2] 屈红[3] 吴琼娅[1] 王非凡[3] 翁湘[4] 

机构地区：[1]宜昌市第一人民医院手术室,湖北宜昌443000 [2]宜昌市第一人民医院神经内科,湖北宜昌443000 [3]宜昌市第一人民医院护理部,湖北宜昌443000 [4]宜昌市第一人民医院质控办,湖北宜昌443000

出　　处：《中华医院感染学杂志》2015年第23期5453-5455,共3页Chinese Journal of Nosocomiology

基　　金：湖北省自然科学基金资助项目(2011CDB512)

摘　　要：目的研究根本原因分析法(RCA)对胃肠手术患者切口感染的预防效果,为临床治疗提供参考依据。方法选择2013年3月-2015年1月在医院收治的280例胃肠手术患者,随机分为研究组和对照组,各140例,对照组患者在手术过程中采用传统干预方法,研究组患者采用根本原因分析法进行干预;对比患者切口感染病原菌的分布及耐药性,数据采用SPSS 16.0软件进行统计分析。结果研究组中共有3例患者术后发生切口感染,感染率为14.3%,低于对照组的35.7%;70例切口感染患者分离出86株病原菌,其中革兰阴性菌为主,共47株占54.7%,金黄色葡萄球菌对青霉素耐药率较低,<18.8%;大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌对阿米卡星耐药率较低,均<16.0%。结论 RCA可以降低胃肠手术患者切口感染率,临床治疗的有效率提高。OBJECTIVE To explore the effect of root cause analysis （RCA） on prevention of incision infections in the patients undergoing the gastrointestinal surgery so as to provide guidance for clinical treatment. METHODS A total of 280 patients who underwent the gastrointestinal surgery from Mar 2013 to Jan 2015 were enrolled in the study and randomly divided into the study group and the control group, with 140 cases in each. The control group was treated with conventional interventions during the surgery, while the study group was treated with the RCA method for intervention. The distribution and drug resistance of the pathogens causing the incision infections were observed, and the statistical analysis of data was performed with the use of SPSS16.0 software. RESULTS The in- cidence of intraoperative incision infections was 14. 3% in the study group （3 cases）, lower than 35.7% in the control group. Totally 86 strains of pathogens were isolated from 70 patients with incision infections, of which 54.7%0 （47 strains） were gram-negative bacteria. The drug resistance rate of the Staphylococcus aureus strains to penicillin was less than 18.8 % ; the drug resistance rates of the Escherichia coli, Pseudornonas aeruginosa, and Klebsiella pneumoniae strains to amikacin were less than 16.0%. CONCLUSION The RCA can reduce the inci- dence of incision infections in the patients undergoing the gastrointestinal surgery and raise the effective rate of clinical treatment.

关 键 词：根本原因分析法 胃肠手术患者 切口感染 预防效果 

分 类 号：R619.3[医药卫生—外科学]