某医院开颅清洁术后手术部位感染的危险因素分析  

Risk Factors for Surgical Site Infection after Craniotomy Cleansing Operation in A Hospital

作　　者：李美月 张怡 刘付金龙 林志豪 黄秋玲 黄婷 LI Meiyue;ZHANG Yi;LIUFU Jinlong;LIN Zhihao;HUANG Qiuling;HUANG Ting(Dongguan Kanghua Hospital,Dongguan 523000,China;不详)

机构地区：[1]东莞康华医院,广东东莞523000

出　　处：《中外医学研究》2022年第4期145-148,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：东莞市社会科技发展一般项目(2018507150591243)。

摘　　要：目的:探讨围手术期抗菌药物合理性预防应用和其他影响因素对开颅清洁手术术后手术部位感染的影响,为术后手术部位感染防控提供参考。方法:回顾性分析2015年9月-2020年9月东莞康华医院收治的开颅清洁手术患者542例的临床资料,观察手术部位感染情况。围手术期预防应用抗菌药物使用情况包括品种选择、给药时机、术后24 h停药等,其他影响因素包括性别、年龄、开颅清洁手术持续时间、开颅清洁手术术中出血量、住院期间颅脑手术次数等。分析开颅清洁手术患者手术部位感染的可能独立危险因素。结果:542例开颅清洁手术患者术后手术部位感染29例,感染率为5.35%。是否首剂术前0.5~1 h给药、术后24 h停药及住院期间颅脑手术次数不同患者的感染发生率比较,差异有统计学意义(P<0.05)。术后24 h停药是手术部位感染的独立保护因素,住院期间手术次数则是独立危险因素(P<0.05)。结论:开颅清洁手术术后手术部位感染的影响因素较多,其中,减少患者住院期间颅脑手术次数,加强围手术期抗菌药物合理性应用,尤其是术前0.5~1 h给药及术后24 h停药有助于减少手术部位感染。Objective:To explore the effect of rational preventive application of antimicrobials during perioperative period and other influencing factors on surgical site infections after craniotomy cleansing operation,and to provide references for postoperative surgical site infection prevention and control.Method:The clinical data of 542 patients undergoing craniotomy cleansing operation in Dongguan Kanghua Hospital from September 2015 to September 2020 were retrospectively analyzed to observe the situation of surgical site infection.The use of preventive use of antibacterial drugs included variety selection,timing of administration and 24 h postoperative withdrawal,etc,other influencing factors included gender,age,duration of craniotomy cleansing operation,intraoperative blood loss of craniotomy cleansing operation,and number of craniocerebral operations during hospitalization.The possible independent risk factors of surgical site infection in patients undergoing craniotomy cleansing operation were analyzed.Result:There were 29 cases of postoperative surgical site infection in 542 patients undergoing craniotomy cleansing operation,and the infection rate was 5.35%.There were statistically significant differences in the incidence of infection among patients with the drug was administered 0.5-1 h before operation,the drug withdrawal 24 h after operation and the number of craniocerebral operations during hospitalization (P<0.05).Drug withdrawal 24 h after operation was an independent protective factor of surgical site infection,the number of operations during hospitalization was an independent risk factor (P<0.05).Conclusion:There are many factors influencing surgical site infection after craniotomy cleansing operation.Among them,reduce the number of craniotomy operations during hospitalization,strengthen the rational application of antibacterial drugs in the perioperative period,especially 0.5-1 h before operation,drug withdrawal 24 h after operation can reduce infections at the surgical site infection.

关 键 词：开颅清洁手术 手术部位感染 预防应用抗菌药物 

分 类 号：R651.1[医药卫生—外科学]