摘要
目的探讨普外科老年患者切口感染的相关因素，为临床防治切口感染提供依据。方法回顾性分析我院普外科2009年2月至2013年12月收治的2985例行外科手术治疗的老年患者临床资料。将发生切口感染患者作为观察组，未发生切口感染患者作为对照组；对切口感染的相关因素进行单因素分析和多因素Logistic回归分析。结果91例患者发生切口感染，切口感染发生率为3．0％。观察组平均年龄（67．3±5．8）岁大于对照组（63．0±5．6）岁（t=1．906，P=0．028）。观察组平均手术时间（2．13±0．26）长于比对照组（1．87±0．24）h（t=10．149，P〈0．001）。观察组平均切口长度（8．14±2．62）cm长于对照组（7．59±2．14）cm（t=2．396，P=0．008）。观察组预防性抗菌药物应用率74．7％低于对照组83．3％（X^2=4．819，P=0．032）。观察组营养不良率20．9％，高于对照组10．0％（X^2=11．418，P=0．001）。观察组合并糖尿病比率11．0％，高于对照组5．1％（X^2=5．968，P=0．015）。年龄（OR=1．89）、手术时间（OR=3．32）、营养状况（OR=2．08）和合并糖尿病（OR=3．18）是手术治疗患者发生切口感染的独立危险因素。结论影响患者发生切口感染的因素多，医务工作者应针对引发切口感染的危险因素，做好相应的防治措施，尽量避免切口感染发生。
Objective To explore factors associated with incision infection in elderly patients undergoing general surgery and thus provide a basis for its clinical prevention. Methods Retrospective clinical data of 2985 elderly patients who underwent routine surgical operation after admission to the Department of General Surgery from Feb. 2009 to Dec. 2013 were analyzed. Patients with incision infection following surgery were assigned into the infection group, while patients without incision infection served as the control group. Single factor analysis and multivariate Logistic regression analysis were conducted to identify factors responsible for incision infection, Results There were 91 cases with incision infection, constituting a rate of 3.0%. Compared with the control group, patients in the infection group showed an older average age [（67.3±5.8） years vs. （63.0±5.6） years, t=1. 906, P〈0.05], a longer average operating time [（2. 13±0.26） hours w （1.87± 0.24） hours, t= 10. 149, P（0. 001], and a longer average incision length （（8.14 ± 2.62） cm vs. （7.59±2.14） cm, t=2. 396, P〈0.01]. In addition, compared with the control group, more patients in the infection group received prophylactic antibiotics （74.7% vs. 83.3%,X^2 =4. 819, P=0. 032）, exhibited malnutrition （20.9% vs. 10.0%, X2 = 11. 418, P= 0. 001）, and had diabetes mellitus （11.0% vs. 5.1%, X^2 = 5. 968, P = 0. 015） . Therefore, independent risk factors for incision infection included age （OR=1. 89）, operating time （OR=3.32）, nutritional status （OR=2.08） and diabetes mellitus （OR=3.18）. Conelusions A few risk factors may contribute to incision infection. Clinicians should take necessary preventive measures accordingly to minimize its occurrence.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2014年第6期632-634,共3页
Chinese Journal of Geriatrics
基金
浙江省医药卫生研究计划（2012ZYC-A77）
关键词
外科手术
感染
危险因素
Surgical operation
Infection
Risk factors
