产妇会阴侧切术后感染危险因素与预防措施  

Risk factors for postoperative infections in puerpera undergoing episiotomy and prevention measures

作　　者：尹洪花[1] 卢艳霞[2] 朱丙烟[3] 王珊珊[1] 王飞[1] 

机构地区：[1]滨州市人民医院产科,山东滨州256600 [2]滨州市人民医院ICU,山东滨州256600 [3]滨州市人民医院放射科,山东滨州256600

出　　处：《中华医院感染学杂志》2016年第1期158-160,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(ZR2009CL018)

摘　　要：目的探讨产妇会阴侧切术后感染病原菌特点及相关危险因素,为临床防治会阴侧切术后感染提供依据。方法回顾性分析2012年3月-2015年4月在产科住院1 200例阴道分娩行会阴侧切术的足月产妇临床资料,统计其病原菌分布,采用多因素logistic回归分析对相关危险因素进行分析;采用SPSS20.0软件进行统计分析。结果 1 200例产妇术后发生30例会阴切口感染,感染率为2.50%;送检标本中共检出病原菌92株,其中革兰阴性菌58株占63.04%,革兰阳性菌30株占32.61%,真菌4株占4.35%;单因素分析发现,年龄>30岁、体质量指数>28kg/m2、阴道产检>3次、急诊分娩、产程>8h、术后住院时间>5d、胎膜早破、夏季分娩、产妇生殖道感染、切口长度>3cm、缝合人员工作时间≤10年、合并基础疾病是产妇会阴侧切术后感染的危险因素(P<0.05);多因素logistic回归分析发现,体质量指数>28kg/m2、阴道产检>3次、术后住院时间>5d、胎膜早破、产妇生殖道感染、合并基础疾病是产妇侧切术后发生感染的独立危险因素(P<0.05)。结论产妇会阴侧切术后感染病原菌、感染相关危险因素较多,需采取相应干预措施,以降低会阴侧切术后感染率及预防切口感染。OBJECTIVE To explore the characteristics of pathogens causing postoperative infections in the puerpera undergoing episiotomy and analyze the related risk factors so as to provide guidance for clinical prevention and treatment of the postoperative infections after the episiotomy.METHODS A total of 1 200full-term puerpera who underwent the episiotomy for vaginal delivery from Mar 2012 to Apr 2015 were enrolled in the study,the clinical data of the subjects were retrospectively analyzed,the distribution of pathogens was taken for statistics,the multivariate logistic regression analysis was carried out for the related risk factors,and the statistical analysis was performed with the use of SPSS20.0software.RESULTS Of 1 200 puerpera,30had postoperative perineal incision infections with the infection rate of 2.50%.Totally 92 strains of pathogens were isolated from the submitted specimens,including 58（63.04%）strains of gram-negative bacteria,30（32.61%）strains of gram-positive bacteria,and 4（4.35%）strains of fungi.The univariate analysis showed that the risk factors for the postoperative infections in the puerpera undergoing the episiotomy included the more than 30 years of age,body mass index more than 28kg/m2,more than 3times of vaginal birth check,emergency childbirth,more than 8hours of labor stage,postoperative hospitalization duration more than 5days,premature rupture of membrane,delivery in summer,genital tract infection,incision length more than 3cm,service life of suture staff no more than 10 years,and complication of underlying diseases（P〈0.05）.The multivariate logistic regression analysis indicated that the independent risk factors for the postoperative infections in the puerpera included the body mass index more than 28kg/m2,more than 3times of vaginal birth check,postoperative hospitalization duration more than 5days,premature rupture of membrane,genital tract infection,and complication of underlying diseases（P〈0.05）.CONCLUSION There are a variety of related risk factors for the postop

关 键 词：会阴侧切术 病原菌 感染 危险因素 

分 类 号：R619.3[医药卫生—外科学]