胃肠外科患者手术切口感染因素分析及预防对策  

Causes of Surgical Incision Infections in Recipients of Gastrointestinal Surgery and Countermeasures

作　　者：刘庆滨[1] 孟祥彩 陈艳昕[2] LIU Qingbin;MENG Xiangcai;CHEN Yanxin(Department of General Surgery,the First Hospital of Qinhuangdao,Qinhuangdao Hebei 066000,Chin)

机构地区：[1]秦皇岛市第一医院普外科,河北秦皇岛066000 [2]秦皇岛市第一医院病理科

出　　处：《解放军预防医学杂志》2018年第5期595-597,612,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：河北省2017年度医学科学研究重点课题(No.20171258)

摘　　要：目的明确胃肠外科患者手术切口发生感染的潜在因素,制定相应的预防对策,从而降低手术感染的发生风险。方法收集2016-10至2017-10在我院胃肠外科发生手术部位感染的72例患者的临床资料并进行分析,包括手术感染发生情况、致病菌特点及发生手术感染的相关因素分析。结果 (1)手术感染发生情况:对980例患者进行术后调查显示,有72例发生了感染,感染率为7.35%(72/980)。感染者于术后72 h体温均升高至38℃;其中,8例发生手术部位深部间隙感染,64例发生手术切口感染。(2)致病菌特点:对本研究72例手术切口感染患者进行细菌培养,分离培养出合格菌株共52株,阳性率为72.22%(52/72),其中G-菌38株,占73.08%,G+菌14株,占26.92%;大肠埃希菌和金黄色葡萄球菌的感染占比均较高,分别为44.74%和57.14%。(3)发生手术感染的相关因素分析:感染与患者年龄、手术目的、手术类型、切口类型、手术时间及住院时间呈明显相关性,比较差异有统计学意义(P<0.05)。结论应严格控制胃肠外科患者的手术条件和手术环境,做好术前、术中及术后的护理,合理使用抗菌药物,争取帮助患者早日康复出院。Objective To identify the potential factors of surgical incision infections in recipients of gastrointestinal surger-y, and to formulate corresponding measures to reduce the risk of surgical infections. Methods The clinical data of 72 cases of surgical infections as a result of gastrointestinal surgery treated in our hospital between October 2016 and October 2017 was ana-lyzed, including the incidence of surgical infections, characteristics of pathogenic bacteria and related factors of surgical infec-tions. Results （1）Incidence of surgical infections. Postoperative investigations of 980 patients showed that 72 cases were infected, and that the infection rate was 7. 35％ （72/980）. The body temperature of the infected patients increased to 38 degrees after 72h, including 8 cases of deep space infections at the sites of surgery and 64 cases of surgical incision infections. （2） Characteristics of pathogenic bacteria. In this study, 72 cases of hand incision infections were subjected to bacterial culture. 52 strains were isolated and cultured, and the positive rate was 72. 22％ （52/72）. Among them, there were 38 strains of G- bacteria, accounting for 73. 08％, and 14 strains of G＋bacteria, accounting for 26. 92％. The percentage of Escherichia coli and Staphylococcus aureus in-fections was higher, making up 44. 74％ and 57. 14％, respectively. （3） Analysis of related factors of surgical infections. Infec-tions were significantly correlated with age, purposes of surgery, types of surgery, types of incision, time of surgery and time of hos-pitalization, and the difference was statistically significant （P〈0. 05）. Conclusion The operating conditions and environment for re-cipients of gastrointestinal surgery should be under rigorous control. Preoperative, intraoperative and postoperative nursing should be of high quality. Antibiotics should be used properly. All this can contribute to early recovery.

关 键 词：胃肠外科 手术切口 预防感染 潜在因素 

分 类 号：R656[医药卫生—外科学]