神经外科Ⅰ类切口术后感染影响因素分析  

Analysis of influencing factors of postoperative infections of type Ⅰ incision in neurosurgery

作　　者：李恒爱[1] 刘大钺[2] 卢建军[1] 杨超[3] 

机构地区：[1]中山大学附属第一医院病案管理科,广东广州510080 [2]中山大学附属第一医院医院医院感染管理科,广东广州510080 [3]中山大学附属第一医院神经外科,广东广州510080

出　　处：《中华医院感染学杂志》2017年第17期3940-3943,共4页Chinese Journal of Nosocomiology

基　　金：广东省科技计划基金资助项目(2013B090500098)

摘　　要：目的探讨神经外科Ⅰ类切口术后感染的影响因素,为医院感染预防控制提供参考依据。方法采用回顾性分析方法,对2011年1月-2014年6月分别在Ⅰ级和Ⅲ级洁净手术室进行手术的2 625例神经外科Ⅰ类切口手术资料进行分析,内容包括患者性别、年龄、BMI、术前住院天数、手术时间、失血量、高血压、糖尿病史、预防使用抗菌药物情况、手术所在洁净手术室等级及静态空气培养情况等;比较术后感染率、洁净手术室静态空气培养合格率,并分析Ⅰ类手术术后感染的相关影响因素。结果 2 625例手术患者中有74例发生术后感染,感染率为2.82%;Ⅰ级和Ⅲ级洁净手术室的术后感染率分别为2.66%和3.01%,手术室静态空气培养合格率分别为93.75%和96.88%,差异均无统计学意义。单因素和多因素分析结果显示,年龄、术前住院天数、失血量、高血压、糖尿病史与神经外科Ⅰ类手术术后感染密切相关,是术后感染发生的独立危险因素(P<0.05)。结论术后感染的影响因素是多方面的,手术室洁净度、抗菌药物预防使用等只是其中部分因素;在临床工作中,应按照规范要求,注重患者围术期管理,缩短术前住院天数,加强手术麻醉管理等,以有效降低术后感染的发生。OBJECTIVE To explore the influencing factors for postoperative infections of type I incision in neurosurgery,so as to provide a basis for nosocomial infection control.METHODS A total of 2625 cases with type I incision operation in neurosurgery from Jan.2011 to Jun.2014 were retrospectively analyzed.Operations were done in Class I and Class III clean operating rooms.The clinical data included sex,age,BMI,preoperative hospitalization days,operation time,blood loss,hypertension,diabetes history,use of antibiotics,grade of clean operation room of operation and static air culture,etc.The postoperative infection rate and qualified rate of static air culture of clean operation room were compared,and influencing factors for postoperative infections of type I incision were analyzed.RESULTS Totally 74 cases had postoperative infections and the infection rate was 2.82%.Infection rates in Class Ⅰ and Ⅲ clean operating rooms were 2.66%and 3.01%respectively,while the qualified rates of static air culture of operating rooms were respectively 93.75%and 96.88%.Both differences were not significant.Univariate and multivariable analysis showed that age,preoperative hospitalization days,blood loss,hypertension and diabetes were independent risk factors for postoperative infections of type I incision in neurosurgery（P〈0.05）.CONCLUSION The influencing factors of postoperative infections are various,the cleanliness level of operation room and prophylactic use of antibiotics are only parts of the factors.According to the regulation,it is necessary to improve perioperative management,shorten the preoperative hospitalization days,and improve operation anesthesia management in clinical work to reduce postoperative infections efficiently.

关 键 词：神经外科 Ⅰ类切口 术后感染 影响因素 

分 类 号：R651[医药卫生—外科学]