云南省广南县人民医院手术部位感染117例危险因素分析  

Risk factors of surgical site infection in 117 patients from People's Hospital of Guangnan Hospital of Yunnan province

作　　者：余英 许姜姜[2] 周杰 罗元章 倪士棋 刘恋 吴一波[3] Yu Ying;Xu Jiangjiang;Zhou Jie;Luo Yuanzhang;Ni Shiqi;Liu Lian;Wu Yibo(Department of Sensory Control,People's Hospital of Guangnan Hospital of Yunnan Province,Guangnan 663300,Yunnan Province,China;Department of Sensory Control,Children's Hospital of Shanghai,Children's Hospital of Shanghai Jiaotong University,Shanghai 200062,China;Department of General Surgery,Children's Hospital of Shanghai,Children's Hospital of Shanghai Jiaotong University,Shanghai 200062,China)

机构地区：[1]云南省广南县人民医院感控科,663300 [2]上海市儿童医院,上海交通大学附属儿童医院感控办,200062 [3]上海市儿童医院,上海交通大学附属儿童医院普外科,200062

出　　处：《中国基层医药》2021年第4期597-601,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:通过手术部位感染的危险因素分析,为感染防控提供科学依据,实现感染防控的关口前移。方法:从医院信息系统提取2016年11月至2019年8月入住广南县人民医院普外科和骨科的手术患者信息。根据术后是否发生手术部位感染,将患者分为感染组和非感染组。通过logistic回归模型,分析手术部位感染的危险因素。结果:共纳入9346例手术病例,其中感染组117例,手术部位感染发生率为1.25%。多因素分析结果显示,低蛋白血症(OR=2.585)、非清洁切口(OR值分别为3.243和5.125)、手术持续时间超过3 h(OR=2.315)、输血(OR=2.239)、放置引流管(OR=2.133)以及留置导尿管(OR=1.973)是发生手术部位感染的独立危险因素,而术前预防使用抗菌药物是保护因素(OR=0.383)。结论:患者个人因素、手术相关因素及术后诊疗相关因素均与手术部位感染的发生密切相关。临床需特别关注患者术前低蛋白血症、围术期预防用抗菌药物以及术后引流管、导尿管留置等问题。Objective To provide scientific evidence for infection prevention and control by analyzing the risk factors of surgical site infection,which can move forward the gateway of infection prevention and control.Methods The surgery-related information of patients admitted to the Department of General Surgery and Department of Orthopedics,People's Hospital of Guangnan Hospital of Yunnan province from November 2016 to August 2019 was retrospectively analyzed.According to whether postoperative surgical site infection occurred,the patients were divided into an infection group and a non-infection group.Logistic regression model was used to analyze the risk factors of surgical site infection.Results A total of 9346 patients,consisting of 117 patients in the infection group and 9229 patients in the non-infection group,were included for final analysis.In the infection group,the incidence of surgical site infection was 1.25%.Multivariate analysis showed that hypoproteinemia(OR=2.585),unclean incision(OR=3.243 and 5.125),and operation duration more than 3 hours(OR=2.315),blood transfusion(OR=2.239),drainage tube placement(OR=2.133)and indwelling catheter placement(OR=1.973)were the independent risk factors for surgical site infection,while prophylactic use of antibiotics was a protective factor(OR=0.383).Conclusion Individual factors,operation-related factors,and treatment-related factors are closely related to the occurrence of surgical site infection.Much attention should be paid to the clinical issues like preoperative hypoproteinemia,perioperative prophylactic use of antibiotics and postoperative drainage tube and indwelling catheter placement.

关 键 词：外科伤口感染 危险因素 低蛋白血症 抗菌药物 引流 导尿管 

分 类 号：R619.3[医药卫生—外科学]