摘要
目的分析剖宫产手术切口感染的危险因素,为制定有效的预防措施提供科学依据。方法对2010年1月-2011年12月行剖宫产术的1285例孕妇进行回顾性分析,收集手术产妇的基本信息、血压和空腹血糖、手术时间、切口感染和细菌培养等情况,并作分类统计。结果确诊手术切口感染58例66例次,感染率4.5%例次感染率5.1%;共分离病原菌54株,其中革兰阴性菌33株,占61.11%,革兰阳性菌15株,占27.8%,真菌6株,占11.1%,排名前3位病原菌依次为大肠埃希菌、表皮葡萄球菌、白色假丝酵母菌,分别占38.9%、27.8%和11.1%;58例感染最多见的是切口局部红肿痛和渗出液增多,分别占54.6%和36.4%;生殖道感染、妊期高血压疾病、急诊手术、手术时间较长、职业及不良个人卫生习惯等是切口感染的危险因素。结论强化各项无菌操作制度,制定和落实剖宫产术临床护理途径,在手术前向产妇及其亲属宣讲围手术期的保健知识,治疗已有的生殖道感染,控制产前血压和空腹血糖水平,缩短手术时间,术后加强护理巡视,合理处理局部感染,有助于降低剖宫产手术切口感染率。
OBJECTIVE To analyze the risk factors for surgical incision infections in the puerperae undergoing cesarean section so as to put forward effective prevention measures. METHODS A retrospective analysis was performed for the 1285 puerperae who underwent cesarean section from Jan 2010 to Dec 2011, then the general information of the puerperae was collected, and the blood pressure, fasting blood glucose, operation duration, incidence of incision infections, and bacterial culture result were observed and statistically analyzed. RESULTS There were 58 cases with confirmed surgical incision infections, the infection rate was 4.5 %. A total of 54 strains of pathogens were isolated, among which there were 33 （61.11%） strains of gram-negative bacteria,15 （27.8%） strains of gram-positive bacteria, and 6 （ 11.1% ） strains of fungi; Escherichia coli, Staphylococcus epidermidis, and Candidaalbicans ranked the top three species of pathogens, accounting for 38. 9%, 27. 8%, and 11. 1%, respectively. Of the 58 cases of infections, there were 66 case-times of clinical manifestations, among which the local swelling of incision and the increase of percolate were most common, accounting for 54.6% and 36.4%, respectively. The genitourinary tract infection, gestational hypertension, emergency operation, long operation duration, occupation, and poor personal hygiene were the risk factors for the incision infections. CONCLUSION To enhance the aseptic operation, formulate the clinical nursing pathways for cesarean section , preach health knowledge to the puerperae and their family members, treat the genitourinary tract infection, control the prenatal blood pressure and the level of fasting blood glucose, shorten the operation duration, intensify the postoperative nursing inspection, and treat local infections appropriately is conducive to reduce the incidence of surgical incision infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第21期5220-5222,共3页
Chinese Journal of Nosocomiology
基金
浙江省医学会临床科研基金项目(2012ZYC-A77)
关键词
剖宫产手术
切口感染
危险因素
预防措施
Cesarean section
Incision infection
Risk factor
Prevention measure
