妇科恶性肿瘤患者子宫全切术后手术部位感染危险因素  

Risk factors for surgical site infection after total hysterectomy in patients with gynecological malignant tumor

作　　者：张刚 曹文成 李才华[1] 林芳[1] 韩莉 涂琼华[1] 闫卫鹏[3] ZHANG Gang;CAO Wen-cheng;LI Cai-hua;LIN Fang;HAN Li;TU Qiong-hua;YAN Wei-peng(Office of Healthcare-associated Infection Control,Hubei Cancer Hospital,Wuhan 430079,China;Department of Sanitary Inspection,Hubei Center for Disease Control and Prevention,Wuhan 430079,China;Radiology Department,Hubei Cancer Hospital,Wuhan 430079,China)

机构地区：[1]湖北省肿瘤医院医院感染控制办公室,湖北武汉430079 [2]湖北省疾病预防控制中心卫生检验所,湖北武汉430079 [3]湖北省肿瘤医院放射科,湖北武汉430079

出　　处：《中国感染控制杂志》2021年第7期602-606,共5页Chinese Journal of Infection Control

摘　　要：目的探讨子宫全切术后手术部位感染(SSI)的危险因素,为预防和控制SSI提供策略。方法采用回顾性方法调查2014年1月—2019年12月湖北省某肿瘤医院妇科恶性肿瘤患者子宫全切术后SSI情况及检出病原菌,并进行其SSI危险因素分析。结果978例妇科恶性肿瘤患者行子宫全切术,发生SSI 94例,SSI发病率为9.61%,其中表浅切口感染14例(1.43%),器官腔隙感染80例(8.18%)。多因素logistic回归分析显示,术前低蛋白血症[OR=2.3,95%CI(1.3~4.1)]、手术时长超3 h[OR=3.4,95%CI(1.0~10.9)]的患者术后发生SSI的风险增加,是妇科恶性肿瘤患者子宫全切术后发生SSI的独立危险因素。手术感染部位检出病原菌59株,主要为大肠埃希菌(62.71%,37株)。结论妇科恶性肿瘤患者行子宫全切术后SSI发病率较高,术前低蛋白血症,手术时间是SSI的独立危险因素,应采取相应措施。Objective To evaluate the risk factors for surgical site infection(SSI)after total hysterectomy,provide strategies for the prevention and control of SSI.Methods Occurrence and pathogens of SSI in gynecological malignant tumor patients after total hysterectomy in a tumor hospital of Hubei Province From January 2014 to December 2019 was investigated retrospectively,risk factors for SSI were analyzed.Results 978 patients with gynecological malignant tumor underwent total hysterectomy,94(9.61%)of whom had SSI,14(1.43%)were superficial incisional infection,80(8.18%)were organ space infection.Multivariate logistic regression analysis showed that patients with pre-operative hypoproteinemia(OR=2.3,95%CI[1.3-4.1])and operation time more than 3 hours(OR=3.4,95%CI[1.0-10.9])had an increased risk of SSI,which were independent risk factors for SSI after total hysterectomy.59 strains of pathogenic bacteria were isolated from surgical infection site,mainly Escherichia coli(62.71%,37 strains).Conclusion Patients with gynecologic malignant tumor after total hysterectomy have high incidence of SSI,pre-operative hypoproteinemia and operation time are independent risk factors for SSI,corresponding measures should be taken.

关 键 词：手术部位感染 妇科恶性肿瘤 子宫全切术 医院感染 危险因素 

分 类 号：R181.32[医药卫生—流行病学]