摘要
目的探讨妇产科患者发生术后医院感染的危险因素和相关对策,为控制和预防感染提供科学依据。方法收集2009年1月-2011年12月在妇产科行手术治疗的786例患者的临床资料,观察医院感染发生情况,对感染相关危险因素行单因素分析后进入logistic多因素回归分析。结果 786例患者中发生医院感染43例,感染率5.47%,感染部位以泌尿道为主,占27.91%,其次为腹部切口、阴道、呼吸道、皮肤黏膜,分别占23.26%、16.28%、13.95%、11.63%;单因素分析发现医院感染与年龄、手术时间、合并基础疾病、侵入性操作、术后留置导管时间、手术方式、预防性应用抗菌药物等因素有相关性(P<0.05);logistic多因素回归分析发现年龄(OR=3.812,P=0.037)、侵入性操作(OR=2.547,P=0.012)、手术时间(OR=2.804,P=0.041)和合并基础疾病(OR=3.758,P=0.023)是医院感染发生的独立危险因素。结论妇产科术后医院感染是多因素综合作用的结果,其发生率较高,应根据相应的情况,采取有针对性的诊疗措施,密切监测高龄患者,减少侵入性操作,严格无菌操作,预防和降低医院感染的发生。
OBJECTIVE To analyze the risk factors for nosocomial infections after gynecological surgery so as to provide basis for the control and prevention of postoperative infections after the gynecological surgery. METHODS The clinical data of 786 patients who underwent the gynecological surgery in the hospital from Jan 2009 to Dec 2011 were retrospectively analyzed. The possible risk factors associated with the nosocomial infections were firstly analyzed with univariate analysis and then were analyzed with multiple logistic regression method. RESULTS Among 786 patients who underwent gynecological surgery, the nosocomial infections occurred in 43 cases with the infection rate of 5.47% ; the urinary tract was the main infection site, accounting for 27.91%, followed by the surgical incision （23. 26 %）, vagina （ 16. 28 %）, respiratory tract （ 13. 95 %）, and skin and mucous membrane （11.63 %）. The univariate analysis showed that the nosocomial infections after gynecological surgery were closely associated with the age, invasive manipulation, operation duration, underlying diseases, indwelling catheter, surgical method, and prophylactic use of antibiotics; logistic regression analysis indicated that the age （OR = 3. 812,P=0. 037） ,invasive manipulation （OR=2. 547,P=0. 012） ,operation duration（OR= 2. 804, P=0. 041） and underlying diseases （OR= 3. 758 ,P= 0. 023） were the independent risk factors for the nosocomial infections. CONCLUSION The incidence of hospital infections after the gynecological surgery is high and is influenced by many factors, the elderly patients should closely monitored to lessen the invasive operation, and the strict disinfection and isolation as well as the appropriate preventive measures can contribute to the reduction of the incidence of nosocomial infections and to the promotion of elderly patients＇recovery.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第6期1368-1369,1372,共3页
Chinese Journal of Nosocomiology
关键词
妇产科
医院感染
危险因素
Department of obstetrics and gynecology
Nosocomial infection
Risk factor
