全子宫切除术患者医院感染发病率及危险因素调查  

Investigation on incidence and risk factors of healthcare-associated infection in patients undergoing total hysterectomy

作　　者：程莉莉[1] 顾静[1] 张丽岩[1] 张秀月[1] CHENG Li-li;GU Jing;ZHANG Li-yan;ZHANG Xiu-yue(Shengjing Hospital Affiliated to China Medical University,Shenyang Liaoning 110004,China)

机构地区：[1]中国医科大学附属盛京医院,辽宁沈阳110004

出　　处：《中国消毒学杂志》2021年第1期43-46,共4页Chinese Journal of Disinfection

摘　　要：目的分析某三甲医院妇科子宫切除术后患者发生医院感染(HAI)的危险因素。方法选择2016年1月1日—2018年12月31日入住某三级甲等医院妇科病房进行全子宫切除术的患者作为研究对象,收集患者的相关资料进行统计分析。结果所调查的2119例患者中64例发生HAI,感染率3.0%,其中手术部位感染发病率为0.6%。全子宫切除术后患者HAI发生率呈现明显的逐年下降趋势。单因素分析显示,术后患者HAI发生率随年龄增高、手术时间的延长而升高(χ^(2)=15.082,P<0.001;χ^(2)=40.993,P<0.001),恶性疾病患者术后HAI发生率明显高于良性疾病患者(χ^(2)=21.867,P<0.001),腹腔镜手术术后HAI发生率低于其他2种术式(χ^(2)=13.794,P=0.001);围术期输血患者术后HAI发生率高于未输血患者(χ^(2)=21.689,P<0.001)。多因素分析显示,其他解释变量不变时,越年轻的女性术后发生HAI的风险越小;手术时间越长,术后发生HAI的风险越高;围术期输血是术后HAI发生的主要危险因素之一。结论尽量选择创伤小的术式和缩短手术时间,合理进行围术期输血治疗会有效降低HAI的发病率。Objective To analyze the risk factors of healthcare-associated infection(HAI)in patients after hysterectomy in gynecology department of a Grade-A tertiary hospital.Methods Patients who were admitted to the gynecological ward of a Grade-A tertiary hospital for total hysterectomy from January 1,2016 to December 31,2018 were selected as the research object,and relevant data of the patients were collected for statistical analysis.Results 64 of the 2119 patients investigated had HAI,the infection rate was 3.0%,and the incidence of surgical site infection was 0.6%.The incidence of HAI in patients after total hysterectomy showed a significant downward trend year by year.Univariate analysis showed that the incidence of HAI in hospitalized patients increased with age(χ^(2)=15.082,P<0.001)and the prolongation of the operation time(χ^(2)=40.993,P<0.001),the incidence of postoperative HAI in patients with malignant diseases was significantly higher than that in patients with benign diseases(χ^(2)=21.867,P<0.001),and the incidence of HAI after laparoscopic surgery was lower than that of the other two types of surgery(χ^(2)=13.794,P=0.001).The incidence of postoperative HAI in perioperative blood transfusion patients was higher than that in non-transfusion patients(χ^(2)=21.689,P<0.001),and the differences were statistically significant.Multivariate analysis showed that when other explanatory variables remained unchanged,younger women had a lower risk of postoperative HAI;the longer the operation time,the higher the risk of HAI after surgery;perioperative blood transfusion was one of the major risk factors for postoperative HAI.Conclusion Small trauma surgery,shorting operation time,perioperative blood transfusion treatment will effectively reduce the incidence of HAI.

关 键 词：全子宫切除术 医院感染 危险因素 

分 类 号：R169.4[医药卫生—公共卫生与预防医学]