肝胆外科手术切口感染的多因素分析及治疗对策

目的 探讨肝胆外科手术后切口感染的多因素分析及治疗对策.方法 选择医院从2005年5月-2011年8月收治的554例肝胆外科手术患者,通过回顾性调查分析,分析发生手术切口感染的相关因素.结果 554例肝胆外科手术患学中,发生切口感染66例,感染率为11.9％；患者年龄、手术时间、手术切口类型对切口感染率存在差异；年龄＞60岁患者感染率显著高于＜60岁患者,说明老年患者术后切口感染率高；Ⅰ类切口感染率为6.2％,明显低于Ⅱ、Ⅲ类切口的16.0％、23.7％；并且手术时间越长,发生切口感染的概率越高；因而预防肝胆外科术后切口感染,应从患者自身因素及手术操作两方面进行.结论 外科医师一定要加强无菌观念,加强无菌环境及手卫生依从性、尽量缩短手术时间、完善感染管理制度、控制探视人员流量,以最大限度减少手术切口感染的发生率.

Multivariate analysis of incision infections after hepatobiliary surgery and treatment strategies

OBJECTIVE To investigate the multivariate analysis of wound infections after hepatobiliary surgery and treatment strategies.METHODS A total of 554 patients who underwent hepatobiliary surgery from May 2005 to Aug 2011 were selected,the related factors for surgical incision infections were retrospectively analyzed.RESULTS Of 554 patients who underwent hepatobiliary surgery,incision infections occurred in 66 patients with the infection rate of 11.9%;the difference in the rate of incision infections among the age,operation duration and the types of surgical incision was significant;the infection rate of the patients aged more than 60 years was significantly higher than those aged less than 60 years,which indicated that the rate of incision infections was high in the elderly patients after the surgery;the rate of type Ⅰ incision infections was 6.2%,significantly lower than 16.0% and 23.7% of the type of Ⅱ or Ⅲ-type incision;the longer the operation duration was,the higher the incision infection would be;so the incision infections after hepatobiliary surgery should be prevented from paying attention to the patients′ own factors and the surgical procedures.CONCLUSION The surgeon should strengthen the concept of sterilization,sterile environment and the compliance of hand hygiene,shorten the operation time,complete the management system of infection,and control the accessing of the visiting personnel so as to minimize the surgical incision infections.