肝胆外科开腹手术患者医院感染相关因素研究  

Related factors of nosocomial infection in patients undergoing open surgery of hepatobiliary surgery

作　　者：逵艳[1] 陈香娟[2] 张莹[2] KUI Yan CHEN Xiang-juan ZHANG Ying(Nanyang Central Hospital, Affiliated Hospital of Zhengzhou University, Nanyang, Henan 473000, Chin)

机构地区：[1]郑州大学附属医院南阳市中心医院胆道普外科,河南南阳473000 [2]南阳医学高等专科学校,河南南阳473000

出　　处：《中华医院感染学杂志》2017年第4期835-838,共4页Chinese Journal of Nosocomiology

基　　金：河南省基础与前沿技术研究项目(103422511320)

摘　　要：目的研究肝胆外科开腹手术患者医院感染的相关因素,以期掌握患者医院感染部位、病原菌种类等分布特点、耐药性及感染相关指标等,从而降低医院感染率、促进患者早日康复。方法选取2015年7月-2016年8月医院肝胆外科开腹手术发生医院感染45例患者为观察组,并选取同期开腹手术未发生感染45例患者为对照组,统计观察组患者感染部位及病原菌分布,并比较两组机体感染相关指标表达情况,同时比较观察组中不同感染部位者的检测结果。结果观察组患者感染部位以手术切口为主占60.00%,其次为肺部、泌尿系、消化道及其他感染,分别占22.22%、8.90%、4.44%及4.44%;观察组患者共分离出病原菌47株,其中革兰阴性菌37株占78.72%,革兰阳性菌10株占21.28%,主要革兰阴性菌为大肠埃希菌及肺炎克雷伯菌,主要革兰阳性菌为金黄色葡萄球菌;同时观察组机体感染相关指标血清降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)及白细胞介素-8(IL-8)表达水平明显高于对照组,且观察组中不同感染部位者检测结果也存在明显差异,差异有统计学意义(P<0.05)。结论肝胆外科开腹手术患者医院感染部位以手术切口为主,病原菌以革兰阴性菌为主,同时该类患者机体感染相关指标也呈现高表达状态,故应加强对该类患者的监测与干预。OBJECTIVE To study the related factors of nosocomial infection in hepatopancreatic laparotomy,in order to master the characteristics of nosocomial infection and the distribution of pathogens and drug resistance and infection-related indexes,so as to reduce the nosocomial infection rate and promote the early recovery of patients.METHODS A total of 45 patients with hospital infection and open surgery in Department of Hepatobiliary Surgery in our hospital from Jul.2015 to Aug.2016 were selected as observation group,45 patients without infection and with open surgery at the same time were selected as control group,then the infection sites and pathogenic bacteria distribution of observation group were analyzed,and the body infection related indexes of two groups were compared,while the test results of observation group with different infection sites were compared.RESULTS The operative incision was the main infection site of observation group,with the infection rate of 60.00%,and it was obviously higher than 22.22% of pulmonary infection,8.89% of urinary infection,4.44% of digestive tract infection and 4.44% of other sites infection.Totally 47 strains of pathogens were isolated in observation group,including37 strains of gram-negative bacteria and 10 strains of gram-positive bacteria,accounting for 78.72%and 21.28%.The main gram-negative bacteria were Escherichia coli and Klebsiella pneumonia,and the main gram-positive bacteria was Staphylococcus aureus.The serum expression levels of body infection related indexes（PCT,hs-CRP,IL-6and IL-8）of observation group were obviously higher than those of control group,and the detection results of observation group with different infection sites had obvious differences too,and the differences were all statistically significant（all P〈0.05）.CONCLUSION The operative incision is the main hospital infection site of patients with open surgery in Department of Hepatobiliary Surgery,the gram-negative bacteria is the mainly pathogenic bacteria,and the body infection related index

关 键 词：肝胆外科 开腹手术 医院感染部位 病原菌分布 感染相关指标 

分 类 号：R657.3[医药卫生—外科学]