急诊腹腔镜手术患者切口感染的手术室相关危险因素及病原菌特点  

Operating room-related risk factors and pathogen characteristics of incision infection in patients undergoing emergency laparoscopic surgery

作　　者：张玲燕[1] 张玲玲[1] 李海英[1] ZHANG Ling-yan;ZHANG Ling-ling;LI Hai-ying(Taizhou Hospital of Zhejiang Province,Taizhou Zhejiang 317000,China)

机构地区：[1]浙江省台州医院,浙江台州317000

出　　处：《中国消毒学杂志》2021年第9期667-669,673,共4页Chinese Journal of Disinfection

摘　　要：目的探索急诊腹腔镜手术患者切口感染的手术室相关危险因素及病原菌分布特点。方法选取急诊腹腔镜手术患者为研究对象,对可能导致切口感染的手术室相关因素分别进行χ2检验与Logistic多因素分析。结果548例急诊腹腔镜手术患者有31例发生了切口感染,感染发生率为5.66%。感染患者切口分泌物中共检出41株病原菌,其中革兰阳性菌、革兰阴性菌和真菌分别有11株(26.83%)、27株(65.85%)、3株(7.32%)。Logistic回归分析结果显示,非层流手术室、参观人数≥3人、Ⅲ类切口、术中没有保温、术中手术室温度不适宜、手术室空气菌落数≥200 cfu/m^(3)是急诊腹腔镜手术患者发生切口感染的危险因素(OR>1,P<0.05)。结论急诊腹腔镜手术患者切口感染的主要致病菌为革兰阴性菌,与手术室类型、术中参观人数、切口类别、手术室的温度和湿度以及手术室的空气消毒情况等有一定关系,应引起我们的重视。Objective To explore the operating room-related risk factors and pathogen distribution characteristics of incision infection in patients undergoing emergency laparoscopic surgery.Methods The patients with emergency laparoscopic surgery were selected as the research object,and the operating room-related factors that might cause incision infection were analyzed by chi-square test and Logistic multivariate analysis.Results 31 of 548 patients with emergency laparoscopic surgery had incision infection,with an infection rate of 5.66%.A total of 41 strains of pathogens were detected in the incision secretions of infected patients,of which 11(26.83%),27(65.85%)and 3(7.32%)were gram-positive bacteria,gram-negative bacteria and fungi,respectively.Logistic regression analysis showed that non-laminar flow operating room,number of visitors≥3,type Ⅲ incision,no heat preservation during operation,unsuitable temperature in operating room,unsuitable humidity in operating room and colony count in operating room air≥200 cfu/m^(3) were risk factors for incision infection in patients undergoing emergency laparoscopic surgery(OR>1,P<0.05).Conclusion The main pathogenic bacteria for incision infection in patients with emergency laparoscopic surgery is gram-negative bacteria,and it is related to the type of operating room,the number of visitors during the operation,the type of incision,the temperature and humidity and air disinfection of the operating room,which should be paid attention to.

关 键 词：急诊手术 切口感染 手术室消毒 危险因素 致病菌 

分 类 号：R181[医药卫生—流行病学]