老年全髋关节置换术手术室感染危险因素分析及护理干预  

Risk factors and nursing interventions of infection in elderly patients with total hip replacement in Operating Room

作　　者：戴宁[1] 李丹[1] 乐汉娥[1] 冯静[1] 

机构地区：[1]武汉市普爱医院护理部,430034

出　　处：《中华现代护理杂志》2016年第15期2117-2121,共5页Chinese Journal of Modern Nursing

基　　金：湖北省科技计划项目[（2014）11号]

摘　　要：目的：探讨老年全髋关节置换术手术室感染的危险因素，提出相应的干预护理措施并验证措施的实际效果。方法选择2001年1月—2013年12月在武汉市普爱医院行全髋关节置换术的老年患者296例为研究对象，其中术后发生手术切口感染的102例患者作为感染组，术后未发生切口感染的194例患者作为非感染组。收集患者人口统计学资料，病史、血液指标、Harris 功能评分、手术情况以及术后引流时间；采用《院内感染分类诊断标准》进行感染诊断；采用单因素和逐步 Logistic 多元回归方法对老年全髋关节置换术患者的感染危险因素进行分析，并提出护理干预措施。采用方便抽样法选择2014年2月—2015年8月在我院行全髋关节置换术的老年患者56例进行针对性护理，观察护理措施对术后感染的影响。结果单因素分析结果显示，感染组和非感染组患者的血红蛋白、接台手术情况、手术性质、术中人员参观情况和手术时间差异均有统计学意义（P ＜0．01）。Logistic 多元回归分析显示，血红蛋白、接台手术情况、手术性质、术中人员参观情况和手术时间是术后感染的影响因素（P ＜0．01）。对56例全髋关节置换术的老年患者行针对性护理后，术后切口感染率为17．8％（10／56），较2001年1月—2013年12月的术后感染率34．5％（102／296）降低，差异有统计学意义（P ＜0．05）。结论低血红蛋白、接台手术、急诊手术、术中有人员参观和手术持续时间长是老年全髋关节置换术患者术后感染的危险因素，针对危险因素制定针对性的手术室干预对策可明显降低术后感染的发生，值得临床推广。Objective To explore the risk factors of the infection in elderly patients with total hip replacement in Operating Room and study the effects of the targeted nursing interventions to the infection. Methods A total of 296 patients with total hip replacement in our hospital from January 2001 to December 201 3 were included and divided into infection group and control group. Infection group contained 1 02 patients with surgical incision infection and control group contained 1 94 patients without surgical incision infection.The demographic data,medical history,blood index,Harris function score,operation situation and postoperative drainage time were recorded.Infection diagnosis depended on “Diagnose Standard of Nosocomial Infection”.The risk factors were analyzed by single factor analysis and step-wise Logistic multiple regression analysis.The targeted nursing interventions were proposed.The effects of the targeted nursing interventions were studied in 56 patients from February 201 4 to August 201 5.Results Single factor analysis showed that hemoglobin concentrations, joint operations, operative character, visiting during operations and operative time were significantly different between infection group and control group （P 〈0.01 ）.Logistic multiple regression analysis showed that hemoglobin concentrations,joint operations,operative character,visiting during operation and operative time were relative risk factors of postoperative infection （P ＆lt;0.01 ）.The infection ratio of 56 patients with nursing interventions from February 2014 to August 2015 was 17.8% （1 0 /56）,which was significantly decreased comparing with the ratio 34.5% （102 /296）from January 2001 to December 201 3 （P 〈0.05 ）.Conclusions Low hemoglobin concentrations,joint operations, emergency operations,visiting during operation and long operative time are risk factors of postoperative infection in elderly patients with total hip replacement in Operating Room.The targeted nursing interventions can reduce the infection ratio

关 键 词：老年患者 全髋关节置换术 术后感染 危险因素 预防 

分 类 号：R473.6[医药卫生—护理学]