泌尿外科机器人辅助腹腔镜手术后医院感染病原菌及影响因素  

Distribution of pathogens and influencing factors for postoperative nosocomial infection in urology department patients undergoing robot-assisted laparoscopy

作　　者：杨慧宁[1] 杨海宁 郭刚[3] 张娜[1] 张薇 YANG Hui-ning;YANG Hai-ning;GUO Gang;ZHANG Na;ZHANG Wei(The Third Medical Center of Chinese People′s Liberation Army General Hospital,Beijing100039,China;不详)

机构地区：[1]解放军总医院第三医学中心疾病预防控制科,北京100039 [2]武警青海总队医院急诊医学科,青海西宁810000 [3]解放军总医院第三医学中心泌尿外科学部,北京100039 [4]解放军总医院第三医学中心检验科,北京100039

出　　处：《中华医院感染学杂志》2023年第14期2134-2137,共4页Chinese Journal of Nosocomiology

基　　金：军队科学研究基金资助项目(LB2022B010100)。

摘　　要：目的探讨泌尿外科机器人辅助腹腔镜手术后医院感染病原菌及影响因素。方法选取2021年1月-2023年3月解放军总医院第三医学中心在泌尿外科接受机器人辅助腹腔镜手术患者697例为研究对象,对医院感染患者进行痰液、尿液等样本采集,分离培养细菌,分析病原菌分布情况;收集患者临床资料,单因素和多因素分析机器人辅助腹腔镜手术患者发生医院感染的影响因素。结果697例泌尿外科机器人辅助腹腔镜手术后发生医院感染22例,感染率为3.16%,感染部位主要为下呼吸道和泌尿系统,感染病原菌为阴沟肠杆菌、肺炎克雷伯菌和金黄色葡萄球菌。患者年龄、手术时长、尿管插管是泌尿外科机器人辅助腹腔镜手术后医院感染的影响因素(P<0.05),尿管插管是医院感染发生的保护因素(P<0.05)。结论泌尿外科机器人辅助腹腔镜手术后应重点关注老年患者,缩短手术时间,术后及时进行尿管插管,可减少机器人手术后医院感染的发生率。OBJECTIVE To explore the distribution of pathogens and influencing factors for postoperative nosocomial infection in urology department patients undergoing robot-assisted laparoscopy.METHODS A total of 697patients who received robot-assisted laparoscopy in urology department of the Third Medical Center of Chinese People′s Liberation Army General Hospital from Jan 2021to Mar 2023were recruited as the research subjects.The sputum and urine specimens were collected from the patients with nosocomial infection,bacteria were isolated,and the distribution of pathogens was observed.The clinical data were collected from the patients.Univariate analysis and multivariate analysis were performed for the influencing factors for the nosocomial infection in the robotassisted laparoscopy patients.RESULTS Of the 697patients who underwent the robot-assisted laparoscopy,22had postoperative nosocomial infection,with the infection rate 3.16%.Lower respiratory tract and urinary system were the major infection sites.Enterococcus cloacae,Klebsiella pneumoniae and Staphylococcus aureus were dominant among the pathogens causing the infection.The age,operation duration and urinary catheterization were the influencing factors for the postoperative nosocomial infection in the patients undergoing robot-assisted laparoscopy(P<0.05),urinary catheter indwelling was a protective factor for nosocomial infection(P<0.05).CONCLUSIONIt is necessary to focus on the elderly patients,shorten the operation duration and carry out the urinary catheterization in a timely manner after the surgery so as to reduce the incidence of postoperative nosocomial infection in the patients undergoing robot-assisted laparoscopy.

关 键 词：机器人辅助腹腔镜 医院感染 泌尿外科 影响因素 病原菌 

分 类 号：R619.3[医药卫生—外科学]