手术时长对剖宫产术后感染的影响及其相关因素

目的研究剖宫产手术时长对术后感染的影响,讨论剖宫产手术时长的影响因素。方法采用历史性队列研究,选取2016年1月到2017年12月在鄂尔多斯市中心医院进行剖宫产手术的全部患者,共4 860例,其中术后院内感染23例,根据不同手术时长的百分位数分成9组,比较每组术后院内感染率差异。结果不同手术时长百分位数和其RR值进行相关分析得出相关系数r=0.733,差异有统计学意义(P <0.05);患者手术时长≤80百分位数和>80百分位数者术后院内感染率比较存在明显差异(χ~2=5.520,P <0.05),且手术时长>80百分位数的患者术后感染危险性是手术时长≤80百分位数(39min)患者的2.860倍(RR=2.860,P <0.05)。结论随着手术时长的延长,手术感染的危险性逐步提高,且剖宫产手术时长> 80百分位数(39min)术后感染率会明显增高。为降低剖宫产手术时长,需要医生全面了解患者情况,制定合理的手术方案,不断加强手术熟练程度,不断提高处理突发事件能力。

Operation duration as a risk factor for infection after cesarean section

Objective To explore whether operation duration is a risk factor for infection after cesarean section, and the factors affecting operation duration of cesarean section. Methods During the period from January 2016 to December 2017, 4860 patients delivered their babies by receiving caesarean section at Ordos Central Hospital, of whom 23 presented with postoperative nosocomial infection. While the patients were divided into 9 groups according to the percentile of their operation duration, we adopted historical cohort study in this project to investigate the differences in the rate of infection of each group. Results Analysis of the correlation between the percentiles of the operation durations in the 9 groups and their RR values showed a correlation coefficient r = 0.733, and P = 0.025, and the difference was statistically significant(P<0.05).There was a statistically significant difference in the rate of postoperative hospital infection between the patients at ≤ 80 th percentile and those at >80 percentile(χ~2 = 5.520, P<0.05). For those whose duration of surgery was >80 th percentile, the risk of infection was 2.860 times that of those whose duration of surgery was at ≤ 80 th percentile(39 min). Conclusion With the prolongation of the operation duration, the risk of surgical infection increased gradually, and when the operation duration was > 80 th percentile(39 min), the rate of postoperative infection of the cesarean section was significantly increased. Operation duration can be shortened by understanding more about the patient, making proper operating plans, improving operating skills and the ability to deal with emergencies..