肝胆系统疾病患者术后感染危险因素与预防措施研究  

Risk factors for postoperative infections in patients with hepatobiliary system diseases and prevention measures

作　　者：王方平[1] 严富国[1] 周晓峰[1] 石余[1] 沈洁琼 

机构地区：[1]浙江省新昌县人民医院肝胆外科,浙江新昌县312500 [2]宁波市鄞州区第二医院检验科,浙江宁波315100

出　　处：《中华医院感染学杂志》2016年第2期354-356,共3页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金资助项目(ZJ201645367)

摘　　要：目的探究肝胆系统疾病患者术后感染的相关危险因素及预防措施,以降低肝胆系统疾病术后感染发生率。方法对2013年2月-2015年3月医院肝胆外科收治的721例肝胆系统疾病患者临床资料进行回顾性分析,对比两组患者在各项临床指标的差异,分析总结术后感染发病的相关危险因素及预防措施;采用SPSS18.0软件对数据进行统计分析。结果 721例肝胆系统疾病患者中有113例患者术后发生感染,感染率为15.67%;感染部位主要为手术切口、呼吸道、泌尿系统,分别占36.28%、24.73%及20.35%;患者伴有糖尿病,总胆红素、白细胞计数和血红蛋白水平等指标是发生术后感染的影响因素,差异有统计学意义(P<0.05);手术时间、切口长度、术中出血量、使用聚维酮碘清洗切口、抗菌药物种类及术后引流时间对患者术后感染的发生有显著相关性(P<0.05)。结论肝胆系统疾病术后患者感染与多种因素密切相关,有针对性地加强患者的术后护理,能有效降低肝胆系统疾病术后感染的发生率,有利于改善患者的预后。OBJECTIVE To explore the related risk factors for postoperative infections in the patients with hepatobiliary system diseases and put forward the clinical prevention measures so as to reduce the incidence of the postoperative infections.METHODS The clinical data of 721 patients with hepatobiliary system diseases who were treated in the department of hepatobiliary surgery from Feb 2013 to Mar 2015 were retrospectively analyzed,the clinical indicators were observed and compared between the two groups of patients,the related risk factors for the postoperative infections were analyzed,the prevention measures were put forward,and the statistical analysis of data was performed with the use of SPSS18.0software.RESULTS Of 721 patients with hepatobiliary system diseases,113 had the postoperative infections with the infection rate of 15.67%;The surgical incision,respiratory tract,and urinary tract were the major infection sites,accounting for 36.28%,24.73%,and 20.35%,respectively.The incidence of the postoperative infections was influenced by the complication of diabetic mellitus and the levels of total bilirubin,white blood cells,and hemoglobin,and there was significant difference（P〈0.05）.The incidence of the postoperative infections was significantly associated with operation duration,length of incision,volume of intraoperative hemorrhage,use of povidone iodine for cleaning of incision,number of types of antibiotics,and time of postoperative drainage（P〈0.05）.CONCLUSIONThere are a variety of factors closely associated with the postoperative infections in the patients with hepatobiliary system diseases.It is an effective way to strengthen the postoperative care for the patients so as to reduce the incidence of the postoperative infections and improve the prognosis of the patients.

关 键 词：肝胆系统疾病 术后感染 相关危险因素 预防措施 

分 类 号：R181.32[医药卫生—流行病学]