膀胱肿瘤电切除术后患者医院感染的危险因素Logistic回归分析  

Logistic regression analysis of risk factors for postoperative nosocomial infection in bladder tumor patients undergoing electrosurgical resection

作　　者：简毓[1] 吴曦[1] 张鹏[1] 陈安健[1] 黄翔[1] 罗旭[1] JIAN Yu;WU Xi;ZHANG Peng;CHEN An-jian;HUANG Xiang;LUO Xu(Affiliated Hospital of Zunyi Medical College,Zunyi,Guizhou 563000,China)

机构地区：[1]贵州省遵义医学院附属医院泌尿外科,贵州遵义563000

出　　处：《中华医院感染学杂志》2018年第22期3458-3461,共4页Chinese Journal of Nosocomiology

基　　金：贵州省科技合作计划基金资助项目(LH字[2016]5233号)

摘　　要：目的研究膀胱肿瘤电切除术后患者医院感染危险因素。方法选取2015年8月-2017年7月医院行膀胱肿瘤电切除术患者162例,回顾性观察膀胱肿瘤电切除术、目标性监测术后医院感染患者,引入多因素Logistic回归模型分析膀胱肿瘤电切除术后患者医院感染危险因素。结果膀胱肿瘤电切除术后医院感染17例、感染率10.49%,其中以呼吸系统感染为主,占47.06%(8/17)高于泌尿系统35.29%(6/17)、手术切口11.76%(2/17),差异有统计学意义(P<0.05)。年龄(≥60岁)、糖尿病、慢性肺部疾病、膀胱肿瘤位点(多发)、电切除术时间(≥90min)、抗菌药物术前预防使用、膀胱灌注次数(≥5次)、导尿管留置(≥1周)、住院时间(≥28d)、操作人员手卫生(差)、病房环境(差)分别与同组比较,差异有统计学意义(P<0.05)。引入Logistic回归模型分析,糖尿病、慢性肺部疾病、膀胱肿瘤位点、电切除术时间、抗菌药物术前预防使用、膀胱灌注次数、导尿管留置时间、住院时间、操作人员手卫生、病房环境、白蛋白、血红蛋白、白细胞计数水平是膀胱肿瘤电切除术后患者医院感染独立危险因素。结论膀胱肿瘤电切除术后医院感染高危因素多样且采用多因素Logistic回归分析能够及时发现医院感染病例,有助于深度发掘感染原因及本质,早期采取防控措施降低膀胱肿瘤电切除术后医院感染率。OBJECTIVE To explore the risk factor for postoperative nosocomial infection in the bladder tumor patients undergoing electrosurgical resection.METHODS A total of 162 bladder tumor patients who received the electrosurgical resection in the hospital from Aug 2015 to Jul 2017 were enrolled in the study,the targeted monitoring was carried out for the patients who had the postoperative nosocomial infection,and the multivariate logistic regression analysis was performed for the risk factors for the postoperative nosocomial infection.RESULTS Of the patients who received the electrosurgical resection,17 had postoperative nosocomial infection,with the infection rate 10.49%,47.06%（8/17）of whom had respiratory system infection,35.29%（6/17）had urinary system infection,and 11.76%（2/17）had surgical incision infection,and there were significant differences（P〈0.05）.There were significant differences in the age（no less than 60 years of age）,diabetes mellitus,chronic pulmonary diseases,blood tumor sites（multiple）,duration of electrosurgical resection（no less than 90 min）,preoperative antibiotics prophylaxis,no less than 5 times of bladder irrigation,urinary catheter indwelling time no less than 1 week,length of hospital stay no less than 28 days,poor hand hygiene and poor ward hygiene among the patients in the same group（P〈0.05）.The result of the multivariate logistic regression analysis showed that the independent risk factors for the postoperative nosocomial infection in the patients undergoing the electrosurgical resection included the diabetes mellitus,chronic pulmonary diseases,bladder tumor sites,electrosurgical resection duration,preoperative antibiotics prophylaxis,number of times of bladder irrigation,urinary catheter indwelling time,length of hospital stay,hand hygiene and ward environment as well as levels of albumin,hemoglobin and white blood cell.CONCLUSIONS There are a variety of high risk factors for the postoperative nosocomial infection in the bladder tumor patients undergoing e

关 键 词：危险因素 LOGISTIC分析 膀胱肿瘤 医院感染 

分 类 号：R737.14[医药卫生—肿瘤]