子宫下段横切口剖宫产术后切口感染的危险因素探讨

目的:探讨子宫下段横切口剖宫产术后发生手术切口感染(surgical site infection,SSI)的相关危险因素。方法:采用回顾性病例对照的研究方法,对行子宫下段横切口剖宫产术中出现SSI的150例患者及未出现SSI的420例对照患者进行研究。危险因素分析采用单因素及多因素分析方法。结果:SSI的发生与术后出现皮下血肿、入院时体重指数较高、孕期多次阴道检查均有一定关系(P0.01)。经多因素分析发现绒毛膜羊膜炎与SSI并无明显关系(P0.05),其他三者则是SSI发生的独立危险因素(P0.05～P0.01)。结论:术后出现皮下血肿、入院时体重指数较高、孕期多次阴道检查会增加子宫下段横切口剖宫产术后SSI发生的风险。应注意对这些高危患者加强术后监测管理,防止SSI的发生。

The study of risk factors of surgical site infection of low transverse cesarean section

Objective:To explore risk factors of surgical site infection(SSI) of low transverse cesarean section.Methods:The data of 3 765 cases with low transverse cesarean section were retrospective analysed,150 cases with SSI and other 420 control cases were compared,and risk factors were analysed using mono-factor and multi-factor methods.Results:Analysis results showed that SSI was associated with chorioamnionitis,times of vaginal examination,development of subcutaneous hematoma after operation and high body mass index(BMI) at admission hospital(P<0.01).Multivariate analysis showed that the times of vaginal examination,development of subcutaneous hematoma after operation and high BMI at admission hospital were the three risk factors(P<0.05-P<0.01) except chorioamnionitis.Conclusions:The times of vaginal examination,development of subcutaneous hematoma after operation and high BMI at admission hospital can improve the risk of SSI,which suggest that these high risk patiens must be strengthened the monitoring management to prevent SSI.