妇科肿瘤术后盆腔感染的病原菌分布及影响因素分析  

Analysis of pathogen distribution and risk factors of postoperative pelvic infection in patients with gynecologic tumor

作　　者：李翠萍 赵薇 王洋[2] 王娜 杨钰杰 关郁 刘丽晶 LI Cui-ping;ZHAO Wei;WANG Yang;WANG Na;YANG Yu-jie;GUAN Yu;LIU Li-jing(The Third Affiliated Hospital of Qiqihar Medical University Heilongjiang 161000,China)

机构地区：[1]齐齐哈尔医学院附属第三医院妇一科,黑龙江齐齐哈尔161000 [2]齐齐哈尔医学院生理教研室,黑龙江齐齐哈尔161006

出　　处：《中华医院感染学杂志》2019年第15期2357-2360,共4页Chinese Journal of Nosocomiology

摘　　要：目的分析妇科肿瘤患者术后盆腔感染的病原菌分布及影响因素。方法选择2014年5月-2018年3月在医院接受手术治疗的妇科肿瘤患者626例进行研究。收集并统计患者的基本资料,统计患者在术后发生盆腔感染的感染率,分析患者感染的病原菌分布情况以及患者术后盆腔感染的危险因素。结果626例患者中,共有71例发生术后盆腔感染,感染率为11.34%;71例盆腔感染患者的标本检测出病原菌共95株,其中革兰阴性菌占62.11%,革兰阳性菌占28.42%,真菌占9.47%;Logistic回归分析结果显示,妇科肿瘤患者术后盆腔感染的危险因素为:年龄≥60岁、手术时间≥120 min、合并慢性疾病、有盆腔感染史、手术方法为开放式、术前化疗、术后未使用抗菌药物、有术后置管以及术后卧床时间≥7 d(P<0.05)。结论妇科肿瘤患者发生术后盆腔感染的主要病原菌为以大肠埃希菌为代表的革兰阴性菌,且多种因素均可导致此种感染,临床上可通过强化无菌操作、合理应用抗菌药物,以及尽可能地减少病原菌定植等方式预防感染,从而更好地促进患者的康复进程。OBJECTIVE To investigate and analyze the pathogen distribution and risk factors of postoperative pelvic infection in patients with gynecologic tumor.METHODS Totally 626 patients with gynecologic tumor who received surgical treatment in our hospital from May 2014 to Mar.2018 were selected for the study.The patients’basic data information was collected and analyzed,the infection rate of postoperative pelvic infection was calculated,and the distribution of pathogens in the patients and the risk factors for postoperative pelvic infection were analyzed.RESULTS There were 71 cases of postoperative pelvic infection in 626 patients,and the infection rate was 11.34%.A total of 95 strains of pathogens were detected from body fluids or in the vaginal secretions of the 71 patients with postoperative pelvic infection.Gram-negative bacteria accounted for 62.11%,Gram-positive bacteria accounted for 28.42%,and fungi accounted for 9.47%.Logistic regression analysis showed that the risk factors of postoperative pelvic infection in patients with gynecologic tumor were age≥60 years old,operation time≥120 min,complication with chronic disease,pelvic infection history,open surgery,preoperative chemotherapy,not using antibiotics after surgery,postoperative catheterization and postoperative bed time≥7 d(P<0.05).CONCLUSION Gram-negative bacteria represented by Escherichia coli are the main pathogens of pelvic infection in gynecological cancer patients after operation.Many factors can cause this infection.Clinically,infection can be prevented by strengthening aseptic operation,rational use of antibiotics,and minimizing pathogen colonization,so as to better promote the recovery process of patients.

关 键 词：妇科肿瘤 术后 盆腔感染 病原菌 影响因素 

分 类 号：R619[医药卫生—外科学]