普外科胆囊切除术术后切口感染的原因分析及处理  

Cause analysis and treatment of incision infection after cholecystectomy in department of general surgery

作　　者：张海亭[1] 柴虎林 ZHANG Hai-ting(Department of General Surgery,The First Affiliated Hospital of Baotou Medical College,Baotou 014010,China)

机构地区：[1]包头医学院第一附属医院普外一科,014010 [2]不详

出　　处：《中国实用医药》2018年第22期18-19,共2页China Practical Medicine

摘　　要：目的研究普外科患者实施胆囊切除术术后切口感染的原因及对策,以提高疾病治愈率。方法回顾性分析300例接受胆囊切除术患者的临床资料,分析其术后切口感染原因以及处理措施。结果 300例患者中切口感染26例,感染发生率为8.7%。三类切口中,Ⅰ类切口感染发生率为5.0%(4/80),Ⅱ类切口感染发生率为5.0%(5/100),Ⅲ类切口感染发生率为14.2%(17/120)。单因素分析显示:胆囊切除术术后切口感染与患者年龄、切口种类、术中用时、是否糖尿病、体重、是否放置引流管有显著关系。多因素回归分析显示:对单因素分析结果中分析显著的6个变量再进行非条件Logistic逐步回归分析,高龄、高体重、糖尿病、术中用时长、Ⅲ类切口是胆囊切除术术后切口感染高危因素(P<0.05)。结论对本院普外一科胆囊切除术患者切口感染的主要因素进行调查,发现通过学习先进技术缩短切口长度,展开动物实验增强手术熟练度及无菌操作水平,减少手术时间,减少患者术后使用引流管的几率,合理使用抗菌药物等对策,可提高疾病治愈率。Objective To research the causes and countermeasures of incision infection after cholecystectomy in department of general surgery patients, in order to improve the cure rate of disease. Methods The clinical data of 300 patients who underwent cholecystectomy were retrospectively analyzed, and the causes and treatment measures of postoperative incision infection were analyzed. Results Incision infection occurred in 26 cases of 300 patients, the infection rate was 8.7%. Among the three types of incision, the incidence of type Ⅰ incisional infection was 5.0%（4/80）, the incidence of type Ⅱ incision infection was 5.0%（5/100）, and the incidence of type Ⅲ incisional infection was 14.2%（17/120）. Single factor analysis showed that the incision infection after cholecystectomy was significantly related to age, type of incision, intraoperative time, whether there was diabetes, weight, whether or not the drainage tube was placed. Multi factor regression analysis showed that the unconditional Logistic stepwise regression analysis was carried out for 6 significant variables in the single factor analysis. Advanced age, high weight, diabetes, longer intraoperative time, and type Ⅲ incision were the high risk factors for the incision infection after cholecystectomy（P0.05）. Conclusion The main factors of the incisional infection of patients after cholecystectomy in department of general surgery are investigated. Through learning advanced technology to shorten the length of incision, conducting animal experiments to enhance surgical proficiency and aseptic operation level, reduce the operation time and the probability of using drainage tube after surgery, the rational use of antibiotics and other countermeasures, the cure rate of the disease can be improved.

关 键 词：胆囊切除术 切口感染 原因 对策 

分 类 号：R657.4[医药卫生—外科学]