摘要
目的探讨产妇行椎管内麻醉剖宫产手术后医院感染及相关危险因素,为降低剖宫产产妇术后感染率提供依据。方法选择2013年10月-2014年9月收治的1 035例行椎管内麻醉剖宫产产妇为研究对象,对术后发生医院感染的60例产妇感染部位及病原菌分布进行分析。结果 1 035例行椎管内麻醉剖宫产产妇术后感染60例,感染率为5.80%;产妇感染部位主要为手术切口、呼吸道、生殖道及泌尿道,分别占48.33%、25.00%、16.67%及10.00%;共分离出107株病原菌,其中革兰阳性菌51株占47.66%、革兰阴性菌56株占52.34%;logistic回归分析发现胎膜早破、侵入性检查、术中出血量、并发症、手术时间是术后医院感染的独立危险因素(P<0.05)。结论行椎管内麻醉剖宫产产妇术后感染的危险因素较多,应采取措施尽量缩短手术时间、减少组织损伤及术中出血量,合理预防性应用抗菌药物,以降低剖宫产产妇医院感染率。
OBJECTIVE To explore related risk factors for nosocomial infections after cesarean section with intraspinal anesthesia ,so as to provide a basis for reducing infection rates .METHODS Totally 1035 cases of caesarean mothers who received intraspinal anesthesia were selected from Jan .2011 to Sep .2014 in our hospital . The infection sites and pathogen distribution were analyzed through the 60 cases who were infected .RESULTS A total of 60 cases were infected after cesarean section with spinal anesthesia ;the infection rate was 5 .80% ,the maternal infection sites mainly were surgical incision （48 .33% ） ,respiratory tract （25 .00% ） ,reproductive tract （16 .67% ） ,and urinary tract （10 .00% ） .All together 107 pathogens were isolated ,including 51 strains of gram‐positive bacteria ,which accounted for 47 .66% ,and 56 strains of gram‐negative bacteria ,which accounted for 52 .34% .Logistic regression analysis showed that the premature rupture of fetal membranes ,invasive procedures , blood loss ,complications ,and the operation time were independent risk factors for postoperative nosocomial infec‐tions （P〈0 .05） .CONCLUSION The risk factors for infections after cesarean section with spinal anesthesia are va‐rious .Measures should be taken to shorten the operation time ,reduce tissue damage and blood loss .Reasonable prophylactic antibiotic application should be adopted to prevent or mitigate the incidence of nosocomial infections .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第12期2856-2858,共3页
Chinese Journal of Nosocomiology
基金
国家青年自然科学基金资助项目(81300052)
关键词
椎管内麻醉
剖宫产
医院感染
危险因素
Spinal anesthesia
Cesarean section
Nosocomial infection
Risk factors
