CAJ | 학술논문

目的：探讨产妇行剖宫产术后医院感染因素及预防控制措施，为医院感染控制工作提供参考依据。方法选取在2012－2014年行剖宫产手术的产妇1942例作为研究对象，对其术后医院感染率、感染部位等进行分析比较；采用SPSS 13．0软件进行统计分析。结果剖宫产术后产妇医院感染140例，感染率为7．2％，且呈逐年上升趋势；在术后发生医院感染的产妇中，以生殖道感染最多，占44．3％；单因素分析显示，产妇的年龄、妊娠并发症、住院时间、试产时间、放置导尿管、急诊手术、医务人员手术熟练程度及抗菌药物应用时机等与术后医院感染的发生具有相关性（P＜0．05）；多因素 logistic回归分析显示，有妊娠并发症、放置导尿管、手术技术不熟练、术后应用抗菌药物预防感染是剖宫产产妇术后医院感染的独立危险因素。结论剖宫产产妇术后医院感染率较高，其发生与多种因素有关，临床医师根据产妇的高危因素采取相应的干预措施，可有效降低医院感染的发生。
목적：탐토산부행부궁산술후의원감염인소급예방공제조시，위의원감염공제공작제공삼고의거。방법선취재2012－2014년행부궁산수술적산부1942례작위연구대상，대기술후의원감염솔、감염부위등진행분석비교；채용SPSS 13．0연건진행통계분석。결과부궁산술후산부의원감염140례，감염솔위7．2％，차정축년상승추세；재술후발생의원감염적산부중，이생식도감염최다，점44．3％；단인소분석현시，산부적년령、임신병발증、주원시간、시산시간、방치도뇨관、급진수술、의무인원수술숙련정도급항균약물응용시궤등여술후의원감염적발생구유상관성（P＜0．05）；다인소 logistic회귀분석현시，유임신병발증、방치도뇨관、수술기술불숙련、술후응용항균약물예방감염시부궁산산부술후의원감염적독립위험인소。결론부궁산산부술후의원감염솔교고，기발생여다충인소유관，림상의사근거산부적고위인소채취상응적간예조시，가유효강저의원감염적발생。
OBJECTIVE To investigate the risk factors for postoperative nosocomial infections in the puerpera un‐dergoing cesarean section and put forward the prevention measures so as to provide guidance for control of the nos‐ocomial infections .METHODS A total of 1 942 puerpera who underwent the cesarean section from 2012 to 2014 were recruited as the study objects ,then the incidence of postoperative nosocomial infections and infection sites were observed and compared ,and the statistical analysis was performed with the use of SPSS 13 .0 software . RESULTS The postoperative nosocomial infections occurred in 140 cases after the cesarean section with the infec‐tion rate of 7 .2% ,showing an upward trend .Of the puerperal with the postoperative nosocomial infections , 44 .3% had the genital tract infections .The univariate analysis showed that the incidence of the postoperative noso‐comial infections was associated with the age ,pregnancy complications ,length of hospital stay ,time of vaginal de‐livery ,placement of urinary catheter ,emergency surgery ,operation proficiency of medical staff ,and timing of use of antibiotics (P<0 .05) .The multivariate logistic regression analysis indicated that the pregnancy complications , placement of urinary catheter ,unskilled operation ,and postoperative antibiotics prophylaxis were the independent risk factors for the postoperative nosocomial infections in the puerpera undergoing cesarean section .CONCLUSION The incidence of the postoperative nosocomial infections is high in the puerpera undergoing cesareans section ,and the infections are associated with a variety of risk factors .It is necessary for the clinicians to take corresponding in‐terventions aiming at the high risk factors so as to effectively reduce the incidence of the nosocomial infections .