围手术期医院感染322例分析

目的 了解我院的围手术期医院感染情况，探讨其危险因素，为防治提供依据。方法 回顾性调查我院2000年和2001年围手术期医院感染322例，并对易感因素和预后等进行分析。结果 围手术期医院感染率1．7％，死亡18例(5．6％)；易感疾病中以恶性肿瘤最高(33．0％)；术前使用广谱抗生素占97．8％；术前留置尿管占88．2％；气管插管全麻占81．6％；手术时间≥4h占42．1％；感染部位以下呼吸道最常见(38．3％)；感染病原菌以葡萄球菌和真菌最常见，分别占16．3％和13．8％，耐药菌占66．4％；22例肝移植手术医院感染率45．5％，明显高于其他手术，死亡2例(9．1％)。结论 术前使用广谱抗生素、术前留置尿管、全身麻醉、手术时间长和住院时间长为围手术期医院感染的主要危险因素。

Perioperative Nosocomial Infections: An Analysis of 322 Cases

OBJECTIVE To find out perioperative nosocomial infection conditions in our hospital, study their risk factors and provide evidence for infection prevention and treatment.METHODS A total of 322 cases of perioperative nosocomial infections in our hospital in 2000 and 2001 were retrospectively investigated on operation department to analyze the susceptible factors and prognosis. RESULTS Total perioperative nosocomial infection rate was 1.7% and dead rate was 5.6% in 322 cases of 2000 and 2001;malignant tumor was one of the highest susceptible factors (33.0%); broad-spectrum antibiotics weighed 97.8% in preoperative antibiotics used; preoperative urethral catheter used weighed 88.2%; trachea-cathetered general anesthesia weighed 81.6%; more than 4h of operative duration weighed 42.1%; the lower respiratory tract infection was the most frequent infection site and weighed 38.%; staphylococcus and fungi were the most frequent pathogens and weighed 16.3% and 13.8%, respectively; drug-resistant pathogens weighed 66.4%; the infection rate (45.5%) and the dead rate (9.1%) of 22 cases of liver transplantation were higher than those of other operations. CONCLUSIONS Preoperative antibiotics used, preoperative urethral catheter used, trachea-cathetered general anesthesia, operative duration and nosocomial duration were the main risk factors of perioperative nosocomial infections.