宫颈癌患者行腹腔镜手术感染的危险因素分析

Risk factors for perioperative infections in cervical cancer patients undergoing laparoscopic surgery

  • 摘要: 目的 对腹腔镜宫颈癌根治术患者围术期感染及并发症进行临床和护理观察。方法 选取医院2013年1月-2015年12月收住诊疗的220例宫颈癌患者为研究对象,根据护理干预方法不同分为两组,干预组110例采用个体化的规范化护理方法,对照组110例采取常规护理方法,比较两组的围术期感染以及护理满意度。结果 220例行腹腔镜宫颈癌根治术患者出现围术期并发症有31例,发生率为14.1%,其中血管损伤5例、淋巴囊肿9例、尿潴留4例、泌尿系损伤6例、肠道损伤1例、深静脉血栓2例、皮下气肿3例、切口出血1例;共有19例发生感染,感染率为8.6%,术后感染诊断时间为3~16天,平均9.1天;细菌培养结果提示,大肠埃希菌6株,金黄色葡萄球菌5株,粪肠球菌3株,其中个体化护理干预组感染率为6.4%,低于对照组10.9%;干预组护理满意率为81.3%,高于对照组71.8%,差异有统计学意义(P<0.05);经更换抗菌药物及对症治疗后均痊愈出院。结论 个体化规范化护理能够提高腹腔镜宫颈癌根治术患者护理满意度,对于并发症和感染的预防治疗是保证手术效果重要措施。

     

    Abstract: OBJECTIV To observe the risk factors for perioperative infections and complications in cervical cancer patients undergoing laparoscopic radical hysterectomy so as to take nursing interventions. METHODS A total of 220 patients with cervical cancer who were treated in the hospital from Jan 2013 to Dec 2015 were recruited as the study objects and divided into two groups according to the nursing intervention. The intervention group with 110 cases was treated with individualized, standardized nursing measure, while the control group was treated with routine nursing measures. The incidence of perioperative infections and satisfaction with nursing were compared between the two groups. RESULTS Of the 220 patients who underwent the laparoscopic radical hysterectomy, 31 had perioperative complications, with the incidence rate 14.1%, including 5 cases of vascular injury, 9 cases of lymphatic cyst, 4 cases of uroschesis, 6 cases of urinary tract injury, 1 case of intestinal injury, 2 cases of deep venous thrombosis, 3 cases of subcutaneous emphysema, and 1 case of incisions bleeding. Totally 19 patients had infections, with the incidence rate of infection 8.6%. The duration of diagnosis of postoperative infection ranged between 3 and 16 days, with the mean duration 9.1 days. The result of bacterial culture indicated that there were 6 strains of Escherichia coli, 5 strains of Staphylococcus aureus, 3 strains of Enterococcus faecalis. The infection rate of the individualized nursing intervention group was 6.4%, lower than 10.9% of the control group. The rate of satisfaction with nursing was 81.3% in the intervention group, significantly higher than 71.8% in the control groupP<0.05); all the patients were cured and discharged after antibiotics dressing and symptomatic treatment. CONCLUSION The individualized, standardized nursing may raise the satisfaction with nursing among the patients undergoing laparoscopic radical hysterectomy. The prevention and treatment of complications and infection are the important measures to ensure the surgical effect.

     

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