外科Ⅰ类切口手术部位感染发生率及其影响因素分析  

Analysis of infection rate and influencing factors of type Ⅰ incision surgery

作　　者：任海霞[1] 朱欢[2] 高慧儿 邵佳[1] REN Hai-xia;ZHU Huan;GAO Hui-er;SHAO Jia(Department of Pharmacy,First Central Municipal Hospital,Tianjin 300192,China;Department of Prevention&Health Care,First Central Municipal Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院药学部,天津300192 [2]天津市第一中心医院预防保健处,天津300192

出　　处：《中国医院药学杂志》2021年第5期485-489,共5页Chinese Journal of Hospital Pharmacy

基　　金：国家自然科学基金项目(编号:81803356);天津市第一中心医院科技基金(院CM201806)。

摘　　要：目的:调查外科Ⅰ类切口手术部位感染(SSI)发生率及影响因素,以制订SSI防控措施,降低手术部位感染的发生风险。方法:(1)回顾收集天津市第一中心医院2017年1月—2018年12月外科Ⅰ类切口手术患者资料6 986例,统计SSI的发生率;(2)以发生SSI的患者作为感染组,未发生SSI的患者作为非感染组,感染组与非感染组按照性别、年龄、是否预防用药以1∶3比例匹配,应用SPSS软件进行统计,计数资料采用χ2检验,非正态分布计量资料用中位数(M)描述;采用COX比例风险回归模型对发生SSI的病例进行单因素分析和多因素分析。结果:本研究共纳入6 986例Ⅰ类切口手术患者,其中36例SSI,SSI发生率为0.52%;感染组36例,1∶3对应非感染组144例。单因素分析显示,急诊手术、手术时间长(>3 h)、有植入物手术、重要脏器手术、手术>3 h未追加抗菌药物对于增高术后SSI的风险具有统计学意义;多因素分析结果显示,手术>3 h、有植入物手术、重要脏器手术是发生SSI的独立危险因素。结论:外科手术中有植入物手术、长时手术(>3 h)以及重要脏器手术是感染预防的重点,临床中应重视抗菌药物合理的应用,最大程度降低SSI的发生风险。OBJECTIVE To investigate the incidence and influencing factors of surgical site infection(SSI) of type Ⅰ incision surgery to develop SSI prevention and control measures to reduce the risk of surgical site infection.METHODS From January 2017 to December 2018, retrospective review was performed for clinical data of 6 986 patients undergoing type Ⅰ incision surgery and the incidence of SSI calculated. Patients with SSI were assigned into infection group(n=36) while those without SSI non-infected group(n=144). Two groups were matched in a 1∶3 ratio according to gender, age and preventive medication. SPSS software was utilized for statistical processing. And χ2 test was performed for counting data and median(M) description for non-normal distribution measurement data. COX proportional hazard regression model was utilized for conducting uni/multi-factorial analyses for SSI cases.RESULTS Among them, there were 36 cases of SSI with an incidence of SSI at 0.52%. Univariate analysis showed that emergency surgery, long operative duration(>3 h), implant procedure, vital organ procedure and surgery longer than 3 h without additional antimicrobials showed statistical significance in elevating the risk of postoperative SSI. Multivariate analysis indicated that surgery longer than 3 h, implant procedure and vital organ procedure were independent risk factors for SSI.CONCLUSION Surgery with implants, prolonged surgery(>3 h) and important organ procedure are the focal points of infection prevention. Physicians should pay attention to rational use of antibiotics to minimize the risks of SSI in clinical practices.

关 键 词：Ⅰ类切口 手术部位感染 预防用药 危险因素 

分 类 号：R969[医药卫生—药理学]