Ⅰ类手术切口患者术后医院感染特征及影响因素分析

Analysis of infection featureand influencing factors of hospital infection in patients post type Ⅰ incision operation

  • 摘要: 目的 分析Ⅰ类手术患者术后医院感染的特征与影响因素,为制定有效的防控措施提供科学依据。方法 回顾性分析2015年1月-2017年12月某部队医院收治的Ⅰ类手术住院患者5 751例的临床资料,监测患者术后感染情况,分析患者性别、年龄、手术方式,住院时间和侵入性操作等临床资料,归纳Ⅰ类手术切口患者医院感染的影响因素。结果 Ⅰ类手术患者术后医院感染率为4.26%(245/5 751);感染部位下呼吸道为主;共培养分离病原菌261株,其中革兰阴性菌122株占46.74%,以鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌为主;革兰阳性菌86株占32.95%,以金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌为主;真菌53株占20.31%,以白假丝酵母、光滑假丝酵母、热带假丝酵母为主;基础疾病、住院时间、抗菌药物使用时间、呼吸机使用时间、中心静脉插管时间、尿管插管时间是Ⅰ类手术切口患者术后医院感染的影响因素(P<0.05)。结论 Ⅰ类手术患者术后感染率高,应采取积极措施控制风险因素,积极观察患者术后体征,合理使用抗菌药物,尽早拔除不必要的导管,减少交叉感染风险,降低医院感染发生率。

     

    Abstract: OBJECTIVE To analyze the features and influence factors of nosocomial infection in patients post type Ⅰ incision operation, and to provide scientific evidence for effective prevention and control measures.METHODS A total of 5 751 cases of patients with type Ⅰ incision operation admitted to a military hospital from Jan. 2015 to Dec. 2017 were retrospectively analyzed. The postoperative infection was monitored and the clinical parameters including the gender, age, surgical procedure, length of hospital stay and invasive procedure were analyzed, and the influence factors of nosocomial infection of patients post type Ⅰ incision operation were summarized.RESULTS The hospital infection rate of patients post type Ⅰ incision operation was 4.26%(245/5 751); dominated by the lower respiratory tract. 261 strains of pathogens were isolated from co-cultured medium, of which 122 strains of Gram-negative bacteria accounting for 46.74% dominated Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae; 86 strains of Gram-positive bacteria accounting for 32.95% dominated by Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus; and 53 strains of fungus accounting for 20.31% dominated by Candida albicans, Candida glabrata, Candida tropicalis. Basic disease, length of hospital stay, time of use of antibiotics, time of ventilator, time of central venous intubation, time of catheterization of the urethra were identified as the influence factors of patients post type Ⅰ incision operation(P<0.05).CONCLUSION S Vigorous measures should be taken to cope with the high risk factors of nosocomial infection rate of patients post type Ⅰ incision operation. Risk factor of cross-infection and nosocomial infection rate could be reduced by active observation of postoperative signs, reasonable administration of antibiotics, early removal of unneccessary catheters.

     

/

返回文章
返回