肝胆疾病术后切口感染原因分析及防治对策

目的 分析肝胆疾病术后切口感染的原因,探讨其防治对策.方法 回顾性分析肝胆外科200例患者的临床资料,统计其感染发生率,分析感染与性别、年龄、手术切口类型、手术时间、术中应用抗菌药物种类、肝功能及住院时间的关系.结果 200例患者发生感染者共31例,感染率为15.5％；年龄＞60岁患者感染率为18.8％,明显高于≤60岁者的8.1％,Ⅲ型手术切口患者感染率37.5％,明显高于Ⅰ、Ⅱ型切口的3.1％,手术时间及住院时间较长者感染率为30.1％及19.3％,明显高于手术时间、住院时间较短者的5.1％及10.5％,术中应用头孢类患者感染率为20.6％,明显高于应用青霉素者等10.7％,经统计处理差异均有统计学意义(P＜0.05)；而肝功正常与异常者、男女患者发生感染情况,经统计处理差异均无统计学意义.结论 肝胆疾病术后切口感染的发生与年龄、手术切口类型、术中应用抗菌药物种类、手术时间及住院时间密切相关,临床应针对性加以防治.

Risk factors and countermeasures for postoperative incision infection in patients with hepatobiliary disease

OBJECTIVE To analyze the risk factors for postoperative incision infections in patients with hepatobiliary disease and develop countermeasures.METHODS The clinical data of 200 cases of patients underwent hepatobiliary surgery in our hospital were retrospective analyzed.The incidence of infection,relationship between the infection and gender,age,type of incision,operative time,intraoperative antibiotics types,liver conditions and hospitalization time were analyzed.RESULTS Infection occurred in 31 cases of totally 200 patients,with the incidence of 15.5%;infection rate was significantly higher in these patients >60 years old(18.8%) than patients ≤60 years(8.1%);infection rate was higher in patients with type Ⅲ of incision(37.5%) than type Ⅱ type Ⅰ cut(3.1%);infection rates were higher in patients experienced longer operative time(30.1%) and hospitalization time(19.3%) than shorter operative time(5.1%) and hospitalization time(10.5%);infection rate was higher with intraoperative application of cephalosporins(20.6%) than the application of penicillin(10.7%),statistically significant differences were observed(P<0.05),no significant difference was found comparing different liver function or the genders.CONCLUSION The incidence of postoperative incision infections of hepatobiliary disease is closely related to the age,type of surgical incision,intraoperative antibiotic types,operative time and length of stay in hospital,and clinicians should pay more attention on these risk factors.