乳腺癌患者手术部位感染循证干预措施研究  

Evidence-based interventions for surgical site infections in patients with breast cancer

作　　者：韩丽蓉[1,2] 李志红[1] 付明桂 马玉萍[2] 韩晶[3] HAN Li-rong;LI Zhi-hong;FU Ming-gui;MA Yu-ping;HAN Jing(Qinghai Red Cross Hospital,Xining,Qinghai 810000,China)

机构地区：[1]青海红十字医院体检科,青海西宁810000 [2]青海红十字医院乳腺科,青海西宁810000 [3]青海红十字医院供应室,青海西宁810000

出　　处：《中华医院感染学杂志》2018年第20期3152-3155,共4页Chinese Journal of Nosocomiology

基　　金：青海省科技厅科技发展计划基金资助项目(14A120102)

摘　　要：目的探讨循证干预措施对乳腺癌患者手术部位感染的应用价值。方法选择2012年1月-2016年6月于医院实施乳腺癌根治术的患者684例,随机分为循证干预组与对照组,各342例。对照组给予常规干预,循证干预组给予循证干预措施进行护理。观察并对比两组乳腺癌患者的手术部位愈合状况、手术部位感染率、住院时间及护理满意度并分析乳腺癌患者术后感染病原菌情况。结果术后循证干预组乳腺癌患者手术部位愈合情况优于对照组(P<0.001);循证干预组6例丙级愈合患者中4例硬结,2例红肿;对照组16例丙级愈合患者中9例硬结,5例红肿,2例裂开;循证干预组患者手术部位感染率为1.75%(6/342)低于对照组4.68%(16/342)(P=0.030)。22例感染患者共培养分离病原菌26株,其中革兰阴性菌16株占61.54%,以铜绿假单胞菌、大肠埃希菌为主;革兰阳性菌10株占38.46%,以金黄色葡萄球菌为主;循证干预组患者住院时间为(10.02±3.21)d少于对照组(12.69±3.57)d(P=0.008);循证干预组满意度为99.12%(339/342)高于对照组92.69%(317/342)(P<0.001)。结论循证干预措施可有效降低乳腺癌患者手术部位感染率,提升护理满意度,具有一定的临床价值。OBJECTIVE To explore the application value of evidence-based interventions for breast cancer patients with surgical site infections.METHODS A total of 684 breast cancer patients underwent radical mastectomy in our hospital from Jan. 2012 to Jun. 2016 were randomly divided into evidence-based intervention group and control group,with 342 cases in each group.The control group was treated with routine intervention measures,whereas the intervention group was treated with evidence-based nursing interventions.The surgical site healing condition,surgical site infection rates,hospitalization time and nursing satisfaction of the two groups of breast cancer patients were observed and compared,and the distribution of pathogens after the operation of breast cancer was analyzed.RESULTS The healing of operative site in the evidence-based intervention group was significantly better than that in control group（P〈0.001）.Among the 6 cases of patients with poor wound healing in the evidence-based intervention group,there were 4 cases of induration and 2 cases of swelling.Among the 16 cases of patients with poor wound healing in the control group,there were 9 cases of induration,5 cases of swelling,and 2 cases of cracking.The infection rate of surgical site was 1.75%（6/342）in the breast cancer patients of the evidence-based intervention group,which was significantly lower than that of the control group 4.68%（16/342）（P=0.030）.In the 22 breast cancer patients with surgical site infections,a total of 26 strains of bacteria were isolated,in which gram-negative bacteria accounted for 61.54%（16 strains）,dominated by Pseudomonas aeruginosaand Escherichia coli,whereas gram-positive bacteria accounted for 38.46%（10 strains）,dominated by Staphylococcus aureus.The hospitalization time of the breast cancer patients in the evidence-based intervention group was（10.02±3.21）d,significantly shorter than that of the control group（12.69±3.57）d（P=0.008）.The patient satisfaction of the evidence-based intervention g

关 键 词：乳腺癌 手术部位感染 循证干预 愈合 

分 类 号：R737.9[医药卫生—肿瘤]