手术患者切口感染的相关危险因素与预防  

Risk factors for surgical incision infections and prevention measures

作　　者：蒙漫史[1] 徐训超 王波[2] 吴邓娃[2] 周鹏[2] 

机构地区：[1]海口市人民医院护理部,海南海口570208 [2]海口市人民医院手术室,海南海口570208

出　　处：《中华医院感染学杂志》2016年第5期1176-1178,共3页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(2012-SZR-04-07 812170)

摘　　要：目的探讨手术室手术患者切口感染的相关危险因素及预防对策,以降低患者切口感染率。方法选择2014年1-12月在医院手术室进行手术的患者1 300例,回顾性收集患者临床资料、手术室现场记录、术中有无参观人员和医院感染监测报告等进行多因素logistic回顾分析,并对手术室切口感染患者病原菌分布进行分析,所有数据均采用SPSS 17.0软件进行统计分析。结果 1 300例手术患者中发生切口感染83例,发生率为6.38%;共检出病原菌83株,革兰阴性菌37株占44.58%,革兰阳性菌42株占50.60%,真菌4株占4.82%,检出前3位的病原菌依次为金黄色葡萄球菌、铜绿假单胞菌、表皮葡萄球菌,分别占19.28%、18.07%,15.66%;多因素logistic分析显示,年龄≥60岁、手术时间≥4h、切口≥5cm、急诊手术、术前未给予抗菌药物、术中参观≥3人是患者术后发生切口感染的独立危险因素(P<0.05)。结论患者年龄、手术时间、抗菌药物使用及手术室术中参观人数多等是发生切口感染的独立危险因素,对相关因素采取有效措施,以控制患者切口感染的发生。OBJECTIVE To explore risk factors for surgical incision infections,and take corresponding measures to prevent infections so as to reduce the infection rate.METHODS A retrospective analysis was conduct on the clinical data of 1 300 patients who underwent surgical operations in the hospital from Jan 2014 to Dec 2014.Risk factors for surgical incision infections were analyzed by using multivariate logistic regression with single factor and multiple factor analysis and distribution of pathogens in infected patients was also analyzed.RESULTS Totally 83 out of1 300 patients were infected,the infection rate was 6.38%.A total of 83 pathogens were detected,including 37（44.58%）strains of gram negative bacteria,42（50.60%）strains of gram positive bacteria and 4（4.82%）strains of fungi.The pathogens ranking first three were Staphylococcus aureus（19.28%）,Pseudomonas aeruginosa（18.07%）and Staphylococcus epidermidis（15.66%）.The multivariate logistic regression analysis showed that age over 60 years,operation time over 4hours,length of incision over 5cm,emergency operation,absence of antibiotics administered before surgery,and noless than 3visitors during operation were the independent risk factors of surgical incision infections（P〈0.05）.CONCLUSION The age,operation duration,antibiotic administration,and many visitors during operation are the independent risk factors of surgical incision infections.Clinicians should take effective measures targeting at the related factors to control the occurrence of incision infections in operation rooms.

关 键 词：手术室 切口感染 危险因素 预防对策 

分 类 号：R632[医药卫生—外科学]