普通外科手术部位感染目标性监测研究

目的通过对徐州医学院附属医院普通外科手术部位感染（SSI）的目标性监测研究,探讨影响手术部位感染的危险因素。方法采用前瞻性目标研究的方法,由医院感染专职人员对普通外科所有手术患者切口情况进行观察,并于手术后1个月进行电话回访,了解手术切口愈合情况。结果1 589例次手术患者中,155例次手术部位发生感染,感染率为9.75%;不同手术类别相同危险指数的手术以剖腹探查手术和结肠手术感染发生最高;有56例患者在出院后发生手术部位感染,随访感染占总感染例数的36.13%,随访感染以Ⅰ、Ⅱ类手术为主;经单因素及多因素Logistic回归分析得出,白蛋白及血红蛋白值异常、急诊手术、失血、切口类型、引流为手术部位感染的危险因素。结论手术危险指数越高,切口污染越严重,SSI发生率就越高;加强手术患者出院后的追踪随访,有助于了解SSI的真实情况;普外科SSI存在着多种危险因素,采取针对性的措施进行目标性监测,才能有效降低SSI的发生率。

Surgical site infection surveillance in general surgery

Objective To analyze the risk factors of surgical site infection in general surgery by post- surgical surveillance. Methods A prospective study was performed on surgical site in patients undergoing general surgery in our hospital and follow-up by phone after 1 month post-surgery to see how the incision healed up. Results 155 patients had surgical site infections in total 1 589 patients undergoing general surgery and the infection rate was 9.75 %. The infection rates were hightest in those undergoing celiotomy or colon surgery. 56 patients appeared with post-discharge surgical site infection, accounting for 36.13% in the whole infection public. Most post-discharge surgical site infection happened in class Ⅰ and class Ⅱ surgery. Albumin and hemoglobin abnormity, emergency surgery, bleeding, incision type and eduction were risk factors of surgical site infection by multivariate Logistic regression analysis. Conclusions The higher the surgical risk index is and the more severely the incision is contaminated, the higher the SSI rate. It will help to realize the real SSI rate by following up to post-discharge surgical patients. There are lots of SSI risk facors in general surgery, so pertinence surveillance should be taken to reduce SSI rates.