CAJ | 학술논문

目的：分析产后出血患者发生院内感染的危险因素及常见病原菌分布情况，为降低产后出血患者感染发生率提供依据。方法选取富阳市妇幼保健院产科2012年1月至2013年12月收治的产后出血患者134例，观察患者感染发生率，并对的临床资料进行病原菌单因素和多因素Logistic回归分析，观察感染的危险因素，并对感染患者的血液进行分析，观察患者常见病原菌分布情况。结果134例中产褥感染42例占31.34％，产科切口感染4例占2.99％；对患者的临床资料进行单因素分析发现，高龄产妇、高危孕产妇、助产或剖宫产、侵入性诊疗、住院时间是导致患者发生感染的危险因素，经Logistic回归分析发现，高危孕产妇、助产或剖宫产、侵入性诊疗、住院时间长是发生感染的独立危险因素；46例感染患者共检出52株病原菌，以革兰阳性菌多见（28株），其中金黄色葡萄球菌15例，占28.85％，革兰阴性菌（22株）以大肠埃希菌为主，共检出11株，占21.15％。结论产后出血感染患者常见病原菌以革兰阳性菌居多，其中高危孕产妇、助产或剖宫产、侵入性诊疗、住院时间长是发生感染的独立危险因素，临床医师在关注出血的同时，需注意感染的发生。
목적：분석산후출혈환자발생원내감염적위험인소급상견병원균분포정황，위강저산후출혈환자감염발생솔제공의거。방법선취부양시부유보건원산과2012년1월지2013년12월수치적산후출혈환자134례，관찰환자감염발생솔，병대적림상자료진행병원균단인소화다인소Logistic회귀분석，관찰감염적위험인소，병대감염환자적혈액진행분석，관찰환자상견병원균분포정황。결과134례중산욕감염42례점31.34％，산과절구감염4례점2.99％；대환자적림상자료진행단인소분석발현，고령산부、고위잉산부、조산혹부궁산、침입성진료、주원시간시도치환자발생감염적위험인소，경Logistic회귀분석발현，고위잉산부、조산혹부궁산、침입성진료、주원시간장시발생감염적독립위험인소；46례감염환자공검출52주병원균，이혁란양성균다견（28주），기중금황색포도구균15례，점28.85％，혁란음성균（22주）이대장애희균위주，공검출11주，점21.15％。결론산후출혈감염환자상견병원균이혁란양성균거다，기중고위잉산부、조산혹부궁산、침입성진료、주원시간장시발생감염적독립위험인소，림상의사재관주출혈적동시，수주의감염적발생。
Objective To analyze the risk factors of nosocomial infection in patients with postpartum hemorrhage and the distribution of common pathogens, and to provide basis for reducing the infection incidence in patients with postpartum hemorrhage.Methods 134 patients with postpartum hemorrhage admitted from Jan. 2011 to Dec.2013 in our hospital were studied.The incidence of infection was observed in patients, and clinical data of patients were analyzed by univariate and multivariate Logistic regression.The risk factors of infection were was observed and blood samples from infected patients were analyzed to observe the distribution of common patho-gens.Results Among the 134 cases, 42 cases had puerperal infection, accounting for 31.34%, and 4 cases had obstetric wound infection, accounting for 2.99%.Univariate analysis showed that advanced maternal age, high-risk pregnant women, midwifery or cesarean section, invasive treatment, and long hospital stay were risk factors for infection.Logistic regression analysis showed that high-risk pregnant women, midwifery or cesarean section, invasive treatment, and long hospital stay were independent risk factors for infection.52 pathogens were detected from 46 patients.28 Gram-positive bacteria were identified, of which 15 cases of were staphylococcus aureus, accounting for 28.85%and 22 Gram-negative bacteria were identified, of which 11 were escherichia co-li, accounting for 21.15%.Conclusions Gram-positive bacteria are the majority in patients with postpartum hemorrhage and infection.High-risk pregnant women, midwifery or cesarean section, invasive treatment, and long hospital stay are independent risk factors for infection.Puerperal infection also need to be noted when post-partum hemorrhage occurs.