Ⅰ类切口手术部位感染信息化监测方法及其效果评价  

Evaluation of the effect of information surveillance method on surgical site infection of class Ⅰ incision

作　　者：谢小莲 姚宏武 白艳玲 刘伯伟 于正浩 刘运喜 杜明梅 XIE Xiao-lian;YAO Hong-wu;BAI Yan-ling;LIU Bo-wei;YU Zheng-hao;LIU Yun-xi;DU Ming-mei(The First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;不详)

机构地区：[1]中国人民解放军总医院第一医学中心疾病预防控制科,北京100853 [2]中国人民武装警察部队宁夏回族自治区总队医院消毒供应室,宁夏银川750001

出　　处：《中华医院感染学杂志》2023年第24期3797-3801,共5页Chinese Journal of Nosocomiology

基　　金：国家卫生健康委卫生发展研究中心医疗机构感控措施证据循证评价及示范基地建设项目(2020-53)。

摘　　要：目的 评价医院感染实时监控系统(RT-NISS)监测Ⅰ类切口手术部位感染(SSI)的效果。方法 利用RT-NISS信息化监测2022年1-6月Ⅰ类切口手术发生SSI情况,经双人检验核对Ⅰ类切口手术分类及SSI的正确性,并与病案首页调取Ⅰ类切口手术数据进行比对。结果 信息化监测法和病案首页调取法监测到的“Ⅰ类切口”手术分别是15 072例和14 346例;经校准确认为17 208例,包括Ⅰ类切口手术8 435例,介入性操作6 496例,Ⅱ、Ⅲ类切口手术错分为Ⅰ类2 277例;信息化监测法和病案首页调取法分类正确率分别为52.56%(7 922/15 072)和57.44%(8 240/14 346);病案首页法Ⅰ类切口手术SSI率0.07%(6/8 240)低于RT-NISS法0.79%(63/7 922),差异具有统计学意义(P<0.001);Ⅰ类切口手术SSI中器官腔隙感染占比最高,达80.95%(51/63);两种方法获得的诊断性操作SSI率均为0,治疗性介入操作SSI率分别为0.06%和0。结论 相对于病案首页调取法,RT-NISS监测Ⅰ类切口手术感染具有较高的效率和准确性,介入性操作的感染率较低,可不进行重点监测。OBJECTIVE To evaluate the effect of real-time automatic nosocomial infection surveillance system(RT-NISS) on monitoring surgical site infection(SSI) of clean incision. METHODS The data of class Ⅰ incision surgery from Jan to Jun 2022 were collected and the classification of type Ⅰ incision surgery and the correctness of SSI were verified by double inspection. The data of type Ⅰ incision surgery were retrieved from the home page of the medical record for comparison. RESULTS The number of “class Ⅰ incision” procedures monitored by the RT-NISS and from the homepage of medical records was 15 072 and 14 346, respectively. A total of 17 208 cases were included, including 8 435 cases of type Ⅰ incision surgery, 6 496 cases of interventional procedures, 2 277 cases of type Ⅱ and Ⅲ incision surgery. The classification accuracy of RT-NISS and the home page retrieval method were 52.56%(7 922/15 072) and 57.44%(8 240/14 346), respectively. The SSI rate of class Ⅰ incision surgery by the medical record homepage method was 0.07%(6/8 240), which was lower than 0.79%(63/7 922) by RT-NISS method, and the difference was statistically significant(P<0.001). The proportion of organ cavity infection in SSI of type Ⅰ incision surgery was the highest, reaching 80.95%(51/63). The SSI rate of diagnostic procedures was 0 in both methods, and the SSI rate of interventional treatment was 0.06% and 0, respectively. CONCLUSION RT-NISS has higher efficiency and accuracy in monitoring the surgical infection of type Ⅰ incision compared with medical record homepage retrieval method. Infection rates of interventional procedures are so low that targeted surveillance is unnecessary.

关 键 词：Ⅰ类切口 手术部位感染 医院感染实时监控系统 病案首页 感染率 

分 类 号：R197.3[医药卫生—卫生事业管理]