| 易爱玲,耿继兵,徐超.外科手术患者手术部位感染现状分析及影响因素研究[J].中国医药导报,2024,21(4):116-118 |
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| 外科手术患者手术部位感染现状分析及影响因素研究 |
| Analysis of current situation and influencing factors of surgical site infection in surgical patients |
| 收稿日期： 修订日期：2023-02-17 |
| DOI：10.20047/j.issn1673-7210.2024.04.27 |
| 关键词: 手术部位感染 外科手术患者 影响因素 医院感染 |
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| 摘要:目的 探讨外科手术患者手术部位感染（SSI）情况及其影响因素。 方法 收集2020年1月至2021年12月于安徽省马鞍山市人民医院行外科手术的5 420例患者的临床资料，记录SSI及病原菌。根据患者SSI情况将其分为感染组（46例）与非感染组（5 374例）。比较两组临床资料，通过多因素logistic回归分析确定SSI的影响因素。 结果 患者SSI发生率为0.85%（46/5 420）。分离出的48株病原菌中革兰氏阴性菌31株（64.58%），革兰氏阳性菌17株（35.42%）。感染组年龄＞65岁、合并糖尿病、全身麻醉、切口类型Ⅲ类、急诊手术、美国麻醉医师协会分级Ⅲ级、术前使用抗菌药物者占比均高于非感染组，手术时间、住院时间均长于非感染组，差异有统计学意义（P＜0.05）。影响因素分析显示，年龄（OR=2.125，95%CI：1.104～4.090）、合并糖尿病（OR=2.585，95%CI：1.327～5.036）、手术时机（OR=2.209，95%CI：1.306～3.736）、手术时间（OR=2.704，95%CI：1.325～5.518）、住院时间（OR=2.767，95%CI：1.348～5.680）、切口类型（OR=2.159，95%CI：1.128～4.325）、术前抗菌药物使用情况（OR= 0.784，95%CI：0.673～0.995）是外科手术患者SSI的影响因素（P＜0.05）。 结论 年龄、糖尿病、手术时机、手术时间、住院时间、切口类型、术前抗菌药物使用是外科手术患者SSI的影响因素，针对上述因素予以早期干预有利于减少SSI。 |
| Abstract:Objective To investigate the status and influencing factors of surgical site infection (SSI) in surgical patients. Methods Clinical data of 5 420 patients undergoing surgical operations in Maanshan People’s Hospital of Anhui Province from January 2020 to December 2021 were collected, and SSI and pathogenic bacteria were recorded. According to SSI status, the patients were divided into infected group (46 cases) and non-infected group (5 374 cases). The clinical data of the two groups were compared, and the influencing factors of SSI were determined by multivariate logistic regression analysis. Results The incidence of SSI was 0.85% (46/5 420). Among the 48 isolates, 31 isolates (64.58%) were Gram negative bacterium and 17 isolates(35.42%) were Gram positive bacterium. The proportion of patients with age ＞65 years old, diabetes mellitus, general anesthesia, type of incision Ⅲ, emergency surgery, American College of Anesthesiologists grade Ⅲ, and preoperative use of antibiotics in the infection group were higher than those in the non-infection group, operation time and hospital stay in the infection group were longer than those in the non-infection group, the differences were statistically significant (P＜0.05). Analysis of influencing factors showed that age (OR=2.125, 95%CI: 1.104-4.090), combined diabetes (OR=2.585, 95%CI: 1.327-5.036), and timing of surgery (OR=2.209, 95%CI: 1.306-3.736), operation time (OR=2.704, 95%CI:1.325-5.518), hospital stay (OR=2.767, 95%CI: 1.348-5.680), incision type (OR=2.159, 95%CI: 1.128-4.325), and preoperative use of antibiotics(OR=0.784, 95%CI: 0.673-0.995) were the influencing factors for SSI in surgical patients (P＜0.05). Conclusion Age, diabetes mellitus, timing of surgery, duration of surgery, length of hospital stay, type of incision, and use of antibiotics are the influencing factors for SSI in surgical patients, and early intervention for these factors is conducive to reducing SSI. |
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