骨科清洁切口手术部位感染监测及危险因素

目的了解骨科清洁切口手术部位感染(SSI)发病率和SSI危险因素。方法对某院2014年4月1日—9月30日实施骨科清洁手术的患者进行SSI监测,分析其危险因素。结果共监测患者665例,发生SSI 14例,SSI发病率为2.11%。单因素分析结果显示,手术类型、皮肤准备方法、ASA评分和手术时间均是骨科清洁切口发生SSI的危险因素(均P0.05)。多因素logistic分析结果显示:传统备皮法、ASA评分Ⅱ级及以上、手术时间≥90 min是骨科清洁手术患者发生SSI的独立危险因素[OR及OR95%CI分别为3.96(1.07-14.70)、6.45(1.97-21.11)、4.08(1.35-12.30)]。结论改良备皮法、ASA评分I级及手术持续时间越短可减少骨科清洁切口SSI的发生,临床在提高患者自身免疫力的前提下,加强医院感染预防与控制,有助于降低骨科清洁切口SSI发病率。

Monitoring on surgical site infection and risk factors for clean wound orthopedic surgery

ObjectiveTo investigate the incidence and risk factors for surgical site infection (SSI) in clean wound orthopedics surgery.MethodsSSI among patients receiving clean wound orthopedic surgery from April 1 to September 30 in 2014 were monitored, risk factors for SSI were analyzed.ResultsA total of 665 patients were monitored, 14 cases(2.11%) of SSI occurred. Univariate analysis showed that types of skin, skin preparation modes, and ASA score were risk factors for SSI in clean wound orthopedic surgery (all P＜0.05）. Multivariate logistic analysis revealed that conventional skin preparation,ASA score ≥ grade Ⅱ, and duration of operation ≥90 minutes were independent risk factors for SSI in patients receiving clean wound orthopedic surgery (OR［95%CI］, 3.96［1.07-14.70］,6.45［1.97-21.11］, and 4.08［1.35-12.30］ respectively）.ConclusionThe improved method of skin preparation, grade I ASA score, and shortening duration of operation can reduce the incidence of SSI in clean wound orthopedic surgery, on the basis of improving the autoimmunization of patients, strengthening prevention and control of healthcare associated infection can reduce the incidence of SSI in clean wound orthopedic surgery.