中华妇幼临床医学杂志（电子版）
中華婦幼臨床醫學雜誌（電子版）
중화부유림상의학잡지（전자판）
CHINESE JOURNAL OF OBSTETRICS & GYNECOLOGY AND PEDIATRICS(ELECTRONIC VERSION)
2014年
4期
516-520
,共5页
蔡大芬%陈红%效小莉%鲍引娣
蔡大芬%陳紅%效小莉%鮑引娣
채대분%진홍%효소리%포인제
妇科外科手术%手术后期间%感染%回归分析
婦科外科手術%手術後期間%感染%迴歸分析
부과외과수술%수술후기간%감염%회귀분석
Gynecologic surgical procedures%Postoperative period%Infection%Regression analysis
目的：探讨妇科手术后发生医院感染的相关因素及其对策。方法选择2008年1月至2012年12月在孝感市中心医院妇科接受妇科手术治疗的2549例患者中,术后发生医院感染的53例患者的临床病历资料为研究对象。采用回顾性分析方法对其临床病历资料进行分析,详细记录患者年龄及术前身体状况、手术时间、手术方式、手术室洁净度、术前准备情况、抗菌药物应用情况、留置尿管时间等,以探讨妇科手术后发生医院感染的相关因素(本研究遵循的程序符合孝感市中心医院人体试验委员会制定的伦理学标准,得到该委员会批准,并征得受试对象的知情同意)。结果本组接受妇科手术治疗后发生医院感染的发生率为2.08%(53/2549)。对与因妇科手术发生医院感染的可能相关因素进行非条件多因素logistic回归分析结果显示,妇科手术术后发生医院感染的相关因素为①患者年龄[OR=1.153,95%CI (1.081~1.231)；P=0.000]；②术前准备情况[OR=4.782,95%CI(1.516~15.088)；P=0.008]；③手术方式[OR=12.735,95%CI(1.549~104.708)；P=0.018]；④手术室洁净度[OR=6.352,95%CI (2.207~18.292)；P=0.001]；⑤手术时间[OR=5.347,95%CI(1.423~18.423)；P=0.004]；⑥留置尿管时间[OR=5.991,95%CI(1.687~21.547)；P=0.003]；⑦术前应用抗菌药物[OR=5.292,95%CI (1.122~24.958)；P=0.035]。结论妇科手术后发生医院感染与多因素有关,应加强对医院感染的管理,重视术前、术中、术后各环节以降低妇科手术后的医院感染率。
目的：探討婦科手術後髮生醫院感染的相關因素及其對策。方法選擇2008年1月至2012年12月在孝感市中心醫院婦科接受婦科手術治療的2549例患者中,術後髮生醫院感染的53例患者的臨床病歷資料為研究對象。採用迴顧性分析方法對其臨床病歷資料進行分析,詳細記錄患者年齡及術前身體狀況、手術時間、手術方式、手術室潔淨度、術前準備情況、抗菌藥物應用情況、留置尿管時間等,以探討婦科手術後髮生醫院感染的相關因素(本研究遵循的程序符閤孝感市中心醫院人體試驗委員會製定的倫理學標準,得到該委員會批準,併徵得受試對象的知情同意)。結果本組接受婦科手術治療後髮生醫院感染的髮生率為2.08%(53/2549)。對與因婦科手術髮生醫院感染的可能相關因素進行非條件多因素logistic迴歸分析結果顯示,婦科手術術後髮生醫院感染的相關因素為①患者年齡[OR=1.153,95%CI (1.081~1.231)；P=0.000]；②術前準備情況[OR=4.782,95%CI(1.516~15.088)；P=0.008]；③手術方式[OR=12.735,95%CI(1.549~104.708)；P=0.018]；④手術室潔淨度[OR=6.352,95%CI (2.207~18.292)；P=0.001]；⑤手術時間[OR=5.347,95%CI(1.423~18.423)；P=0.004]；⑥留置尿管時間[OR=5.991,95%CI(1.687~21.547)；P=0.003]；⑦術前應用抗菌藥物[OR=5.292,95%CI (1.122~24.958)；P=0.035]。結論婦科手術後髮生醫院感染與多因素有關,應加彊對醫院感染的管理,重視術前、術中、術後各環節以降低婦科手術後的醫院感染率。
목적：탐토부과수술후발생의원감염적상관인소급기대책。방법선택2008년1월지2012년12월재효감시중심의원부과접수부과수술치료적2549례환자중,술후발생의원감염적53례환자적림상병력자료위연구대상。채용회고성분석방법대기림상병력자료진행분석,상세기록환자년령급술전신체상황、수술시간、수술방식、수술실길정도、술전준비정황、항균약물응용정황、류치뇨관시간등,이탐토부과수술후발생의원감염적상관인소(본연구준순적정서부합효감시중심의원인체시험위원회제정적윤리학표준,득도해위원회비준,병정득수시대상적지정동의)。결과본조접수부과수술치료후발생의원감염적발생솔위2.08%(53/2549)。대여인부과수술발생의원감염적가능상관인소진행비조건다인소logistic회귀분석결과현시,부과수술술후발생의원감염적상관인소위①환자년령[OR=1.153,95%CI (1.081~1.231)；P=0.000]；②술전준비정황[OR=4.782,95%CI(1.516~15.088)；P=0.008]；③수술방식[OR=12.735,95%CI(1.549~104.708)；P=0.018]；④수술실길정도[OR=6.352,95%CI (2.207~18.292)；P=0.001]；⑤수술시간[OR=5.347,95%CI(1.423~18.423)；P=0.004]；⑥류치뇨관시간[OR=5.991,95%CI(1.687~21.547)；P=0.003]；⑦술전응용항균약물[OR=5.292,95%CI (1.122~24.958)；P=0.035]。결론부과수술후발생의원감염여다인소유관,응가강대의원감염적관리,중시술전、술중、술후각배절이강저부과수술후적의원감염솔。
Objective To analyze the related factors of nosocomial infections after gynecological surgery and its preventive measures.Methods From January 2008 to December 2012,a total of 2 549 patients underwent gynecological surgery in Zhongnan Hospital of Wuhan University.Among them,fifty-three cases with nosocomial infections after gynecological surgery were restrospectively analyzed. The related factors of nosocomial infections were retrospectively analyzed,such as age,operation duration, operative methods,pre-operation preparation,catheterization time,prior antibiotic use,et al.The study protocol was approved by the Ethical Review Board of Investigation of Zhongnan Hospital of Wuhan University.Informed consent was obtained from all participates.Results The incidence rate of nosocomial infection was 2.08% (53/2 549).The unconditional multivariate logistic regression analysis showed that related factors of nosocomial infections after gynecological surgery included age [OR=1.153,95%CI (1.081~1.231);P=0.000],pre-operation preparation[OR=4.782,95%CI(1.516~15.088);P=0.008],operative methods[OR=12.735,95%CI(1.549~104.708);P=0.018],the cleanliness of operation room[OR=6.352,95%CI(2.207~18.292);P=0.001],operation duration[OR=5.347, 95%CI(1.423~18.423);P=0.004],indwelling catheter[OR=5.991,95%CI(1.687~21.547);P=0.003],prior antibiotic use[OR=5.292,95%CI(1.122~24.958);P=0.035].Conclusions There are multiple factors related to nosocomial infections after gynecological surgery.It′s necessary to strength the administration of nosocomial infections and focus on the preoperative,intraoperative and postoperative work to reduce the incidence of nosocomial infections after gynecological surgery.
