某三甲教学医院Ⅰ类切口手术部位感染危险因素分析  

Analysis of risk factors of surgical site infection at class Ⅰ incision in a grade three class A teaching hospital

作　　者：胡承浩 罗清钦 彭民金 来瑞平 谢多双 郭怀兰 郑红梅 HU Chenghao;LUO Qingqin;PENG Minjin;LAI Ruiping;XIE Duoshuang;GUO Huailan;ZHENG Hongmei(Shiyan Taihe Hospital（Affiliated Hospital of Hubei Medical College）,Hubei 442000,China)

机构地区：[1]十堰市太和医院(湖北医药学院附属医院),湖北442000

出　　处：《医学动物防制》2018年第10期919-921,共3页Journal of Medical Pest Control

基　　金：国家级自然科学基金项目(81372998);湖北省教育厅科研基金资助项目(B20112119);湖北省卫生计生护理专项基金(WJ2015HB042);十堰市太和医院院级重点项目(2012ZDFX04)

摘　　要：目的探讨Ⅰ类切口手术部位感染(surgical site infections,SSI)发生的危险因素,为制定Ⅰ类切口SSI防控措施提供理论依据。方法采用病例对照研究,收集某三甲教学医院手术日期为2015年1月~2016年12月的Ⅰ类切口手术病人病例资料,分析SSI情况及其危险因素。结果Ⅰ类切口手术14 023例病人共发生SSI 63例,发生率为0.45%。骨外科Ⅰ类切口手术SSI发生率较高,为0.55%。单因素分析结果表明,不同手术时间(χ2=9.62)、术中出血量(χ2=30.93)、ASA分级(χ2=9.17)、NNIS分级(χ2=10.60)、术前住院天数(χ2=7.07)、术后抗菌药物使用天数(χ2=109.25)的病人SSI发生率不同,差异均有统计学意义(P<0.05)。多因素分析结果显示,手术时间过长和术后抗菌药物使用天数过长是发生Ⅰ类切口SSI的危险因素(OR=2.84和11.87)。结论Ⅰ类切口手术病人SSI发生率与手术时间和术后抗菌药物使用天数等因素有关,应采取相应的预防措施,降低SSI发生率。Objective To evaluate the risk factors of the surgical site infections （SSI） of incision I surgery, so as to provide a scientific basis for the prevention and control of SSI. Methods A retrospective case-control study was conducted in a grade three class A teaching hospital. The data of patients with incision I surgery from January 1 2015 to December 31 2016 were analyzed for SSI and its risk factors. Results 63 patients were defined as SSI among 14 023 cases of incision I surgery, and the incidence of SSI was 0.45%. The incidence of SSI in orthopedics was 0.55%, which was highest relatively. Univariate analysis revealed that the incidence of SSI was statistically significant（ P〈0.05 ）among patient with different operation durations, intraoperative blood losses, ASA classifications, NNIS classifications, days of preoperative hospital stay and postoperative antimicrobial use（X^2= 9.62, 30.93, 9.17, 10.60, 7.07, 109. 25, P〈0.05）. Multivariate analysis showed that longer operation duration and more days of postoperative antimicrobial use were risk factors for SSI in incision I（ OR =2.84＆11.87 ）. Conclusion The incidence of SSI in patients with incision I surgery was associated with the duration of operation and the days of preoperative antimicrobial use. Prevention measures should be taken to reduce the incidence of SSI.

关 键 词：Ⅰ类切口 手术部位感染 危险因素 病例对照研究 多因素分析 

分 类 号：R619[医药卫生—外科学]