妇科恶性肿瘤患者手术后医院感染危险因素分析  

Risk factor analysis for development of a nosocomial infection in patients who underwent surgery for a gynecological malignancy

作　　者：张红岩 高晖[1] 朱晓敏 ZHANG Hong-yan;GAO Hui;ZHU Xiao-min(Jining First People's Hospital,Jining,Shandong,China 272000)

机构地区：[1]济宁市第一人民医院,山东济宁272000

出　　处：《中国病原生物学杂志》2020年第6期708-710,共3页Journal of Pathogen Biology

摘　　要：目的分析妇科恶性肿瘤患者手术后感染的危险因素,为医院感染的防治提供参考。方法选取2014年1月-2016年12月行手术治疗的604例妇科恶性肿瘤患者为研究对象,分析术后感染发生的危险因素,感染部位及感染病原菌种类,统计学软件采用SPSS20.0。结果604例妇科恶性肿瘤患者术后发生医院感染53例,感染率为8.77%。单因素分析显示,住院时间≥21 d、尿管留置时间≥10 d、腹腔或阴道引流管留置时间≥7 d、合并贫血、手术时间≥4 h为妇科恶性肿瘤患者手术后医院感染相关因素(P<0.05);多因素logistic回归分析,合并贫血、合并慢性病、住院时间≥21 d、手术时间≥4 h、尿管留置时间≥10 d为妇科恶性肿瘤患者手术发生医院感染的危险因素(P<0.05)。结论妇科恶性肿瘤患者术后发生医院感染的部位以泌尿系多见,其次为手术部位、下呼吸道、胃肠道、血液及上呼吸道等。大肠埃希菌是妇科恶性肿瘤患者手术后医院感染常见病原菌。采取针对性预防措施,可控制和减少妇科恶性肿瘤患者手术后医院感染的发生。Objectives To analyze the risk factors for development of a nosocomial infection(NO)in patients who underwent surgery for a gynecological cancer and to provide a reference for the prevention and treatment of NOs.Methods Subjects were a total of 604 patients who underwent surgery for a gynecological malignancy from Jan 2014 to Feb 2016.Risk factors for development of an NO after surgery were determined using retrospective analysis.Sites of infection and pathogens types were determined using descriptive analysis.Statistical analysis was performed using SPSS20.0.Results of 604 patients,53 had an NO for a rate of infection of 8.77%.Aχ2 test indicated that the risk of developing an NO after surgery significantly increased with hospitalization≥21 days,placement of a catheter≥10 days,placement of a drainage tube in the abdominal cavity or the vagina≥7 days,having anemia,and an operating time≥4 hours(P<0.05).Multivariate logistic regression analysis indicated that having anemia,having a chronic disease,hospitalization≥21 days,operating time≥4 hours,and placement of a catheter≥10 days were associated with an increased risk of developing an NO(P<0.05).Conclusion Urinary infections were most common infection occurring in patients undergoing surgery for a gynecological malignancy.Other infections were surgical site infections,lower respiratory tract infections,gastrointestinal tract infections,septicemia,and upper respiratory tract infections.Escherichia coli was the most common pathogen causing an NO in patients who underwent surgery for gynecological cancer.Necessary and targeted preventive measures should be taken to control and reduce the incidence of NOs.

关 键 词：妇科恶性肿瘤 医院感染 危险因素 

分 类 号：R378[医药卫生—病原生物学]