脊柱术后并发医院感染的危险因素与对策

目的 对脊柱术后并发医院感染的危险因素进行调查,研究预防控制措施及对策,以降低感染率.方法 选择医院2006年1月-2011年10月脊柱外科手术的950例患者,对感染患者的危险因素进行分析.结果 950例脊柱外科手术患者中共发生医院感染42例,感染率为4.42％；其中以肺部感染为主,占45.24％,尿路感染占26.19％,切口浅层及椎间隙感染占21.42％,深静脉置管相关性感染占7.15％;共培养出43株病原菌,以革兰阴性杆菌为主,占53.49％,革兰阳性球菌占41.86％,真菌占4.65％;手术及住院时间长、抗菌药物使用、置管、气管插管全身麻醉、合并基础疾病、材料置入是感染的主要危险因素.结论 脊柱外科手术后患者感染的危险因素是多方面的,加强对术前、中、后各环节的控制,严格按照标准操作规程进行操作,合理使用抗菌药物,是降低医院感染的重要措施.

Risk factors and countermeasures for nosocomial infections after spinal surgery

OBJECTIVE To investigate the risk factors for nosocomial infections after spinal surgery and study the prevention and control measures and countermeasures to reduce the incidence of infections.METHODS A total of 950 patients who underwent spinal surgery from Jan 2006 to Oct 2011 were chosen,then the risk factors for nosocomial infections were analyzed.RESULTS Of 950 patients investigated,nosocomial infections occurred in 42 cases with the infection rate of 4.42%;among those patients with infections,the patients with pulmonary infections accounted for 45.24%,the patients with urinary tract infections accounted for 26.19%,the patients with shallow incision and intervertebral space infections accounted for 21.42%,and the patients with deep venous catheter-related infections accounted for 7.15%;there were totally 43 strains of pathogens isolated,including gram-negative bacilli(53.49%),gram-positive cocci(41.86%),and fungi(4.65%);long operation duration or hospital stay,use of antibiotics,catheterization,general anesthesia for tracheal catheterization,underlying diseases,and materials implantation were the risk factors for nosocomial infections.CONCLUSION The risk factors for nosocomial infections in the patients undergoing spinal surgery display on many aspects,so it is an effective way to intensify the control of each link of the surgery,operate strictly by referring the standard operation procedure,and reasonably use antibiotics so as to reduce the incidence of nosocomial infections.