高龄产妇剖宫产术后感染的危险因素分析

目的探讨高龄产妇剖宫产术后感染的危险因素。方法选取2018年2月至2020年2月温州市中心医院收治的行剖宫产术的高龄产妇2100例作为研究对象,根据其是否合并术后感染分为感染组(n=42)和非感染组(n=2058),对比两组的年龄、体质指数、是否合并糖尿病、是否合并高血压、营养不良状况、剖宫产史、阴道检查次数、术中出血量、手术时间及留置导尿管时间等临床资料的差异,进而构建Logistics回归模型分析高龄产妇剖宫产术后感染的危险因素。结果42例发生剖宫产术后感染的高龄产妇中,感染部位以生殖道为主,G~-菌感染所占的比例高于G~+菌(68.63%vs.31.37%),其中金黄色葡萄球菌的感染率最高,达19.61%。Logistics多因素回归分析的结果显示,合并糖尿病(OR=1.042,95%CI=1.007~8.978)、营养不良(OR=1.570,95%CI=1.143~2.157)及术中出血量≥500 mL(OR=1.413,95%CI=1.043-1.915)是高龄产妇剖宫产术后感染的独立危险因素(均P<0.05)。结论合并糖尿病、营养不良、术中出血量≥500mL是高龄产妇发生剖宫产术后感染的独立危险因素,应针对上述高危因素积极采取相应的预防措施,有效降低高龄产妇剖宫产术后感染的发生风险,促进产后恢复。

Analysis of risk factors of post-cesarean section in elderly parturient women

Objective To explore the risk factors of infection after cesarean section in elderly parturient women.Methods A total of 2,100 parturient women underwent cesarean section in Wenzhou Central Hospital from February 2018 to February 2020 were enrolled.According to presence or absence of postoperative infection,all of them were divided into infection group(n=42)and non-infection group(n=2,058).The clinical data,including age,body mass index(BMI),diabetes,hypertension,malnutrition,history of cesarean section,times of vaginal examination,intraoperative blood loss,operation time,catheter indwelling time were observed and compared between the two groups,and then related influencing factors of infection after cesarean section in elderly parturient women were analyzed by performing Logistics regression analysis.Results Among the 42 elderly parturient women with postoperative infection after cesarean section,the main infection site was genital tract,and G~-bacteria infection accounted for a higher proportion than G~+bacteria(68.63%vs.31.37%),among which Staphylococcus aureus infection rate was the highest,reaching 19.61%.The results of Logistics multivariate regression analysis showed that diabetes(OR=1.042,95%CI=1.007-8.978),malnutrition(OR=1.570,95%CI=1.143-2.157)and intraoperative blood loss equaled or exceeded 500 mL(OR=1.413,95%CI=1.043-1.915)were independent influencing factors of infection after cesarean section in elderly parturient women(all P<0.05).Conclusion Combined with diabetes,malnutrition and intraoperative blood loss equals or exceeds 500 mL are independent risk factors of infection after cesarean section in elderly parturient women.Therefore,the related preventive measures should be taken to effectively reduce the risk of infection after cesarean section in elderly parturient women and promote postpartum recovery.