2021 年第 12 期 第 16 卷

Ⅰ类切口手术后医院感染危险因素分析及应对策略研究

Risk factors and coping strategies of nosocomial infection after type Ⅰ incision operation

作者：胡黎川1叶晶晶1林宝丽1叶发青2

英文作者：Hu Lichuan1 Ye Jingjing1 Lin Baoli1 Ye Faqing2

单位：1浙江省温州市中心医院药剂科325000；2温州医科大学药学院325000

英文单位：1Department of Pharmacy Wenzhou Central Hospital Zhejiang Province Wenzhou 325000 China; 2School of Pharmaceutical Sciences Wenzhou Medical University Wenzhou 325000 China

关键词：Ⅰ类切口手术；医院感染；危险因素

英文关键词：TypeⅠincisionoperation;Nosocomialinfection;Riskfactors

• 摘要：

• 目的 探讨Ⅰ类切口手术后医院感染的危险因素及应对策略。方法 回顾性分析2019年8月至2020年8月在浙江省温州市中心医院住院治疗的Ⅰ类切口手术后136例发生医院感染患者（感染组）及136例未发生医院感染患者（非感染组）的临床资料。采用Logistic回归方法分析患者医院感染的危险因素，统计患者医院感染部位、感染病原体及抗菌药物使用等情况。结果  该研究时段Ⅰ类切口手术患者医院感染发生率为3.4%（136/3 945）。医院感染患者中，以呼吸道感染最常见，占75.7%（103/136）。136例感染患者送检标本68例，送检率为50.0%，检出病原菌共53株，以革兰阴性菌为主（共33株，占62.3%）。年龄＞60岁、住院时间＞7 d、有基础疾病、术中出血量＞100 ml、术后有引流是Ⅰ类切口手术患者术后医院感染的独立危险因素（均P＜0.05）。136例医院感染患者中有122例使用了抗菌药物治疗，抗菌药物使用率达89.7%。结论  对于Ⅰ类切口手术患者,应缩短平均住院日、减少术中出血量、加强术后引流管理、提高病原菌送检率、规范临床合理用药以减少医院感染的发生。

• Objective To investigate the risk factors and coping strategies of nosocomial infection after type Ⅰ incision operation. Methods The clinical data of 136 patients with nosocomial infection (infection group) and 136 patients without nosocomial infection (non infection group) after type Ⅰ incision operation in Wenzhou Central Hospital, Zhejiang Province from August 2019 to August 2020 were retrospectively analyzed. Logistic regression analysis was used to analyze the risk factors of nosocomial infection, and the location of nosocomial infection, pathogens and use of antibiotics were counted. Results The incidence of nosocomial infection of patients with type Ⅰ incision operation was 3.4%(136/3 945) during the study period. Among the patients with nosocomial infection, respiratory infection was the most common, accounting for 75.7%(103/136). Sixty-eight samples from 136 infected patients were sent for examination, and the sending rate was 50.0%. Fifty-three strains of pathogens were detected, mainly Gram-negative bacteria (33 strains, accounting for 62.3%). Age ＞60 years old, length of stay ＞7 d, basic diseases, intraoperative bleeding ＞100 ml and placement of postoperative drainage were independent risk factors for nosocomial infection in patients with type Ⅰ incision operation(all P＜0.05). One hundred and twenty-two of 136 patients with nosocomial infection were treated with antibiotics, and the utilization rate of antibiotics was 89.7%. Conclusion  In order to reduce the incidence of nosocomial infection after type Ⅰ incision surgery, shortening length of stay, reducing intraoperative bleeding, strengthening postoperative drainage management, improving the examination rate of pathogenic bacteria, and standardizing clinical rational drug use should be taken.