普通外科患者术后手术部位感染的易感因素分析及对策

目的 研究普通外科患者术后手术部位感染的易感因素,探讨防止手术部位感染的方法.方法 将医院普通外科于2010年1月-2011年1月收治行手术治疗的462例患者作为研究对象,按照手术部位感染与否,分为手术部位感染组和正常组,对两组患者的一般资料、诊治资料进行分析,总结普通外科患者术后手术部位感染的易感因素,并探讨针对性预防手术部位感染的对策.结果 462例患者中发生术后手术部位感染43例,手术部位感染发生率为9.3％；感染组和正常组年龄＞60岁分别占51.2％、22.2％；肥胖分别占74.4％、27.4％；合并糖尿病分别占74.4％、16.7％；急诊手术分别占67.4％、16％；污染类手术分别占60.4％、21.2％；手术时间分别为(5.3±2.1)、(3.0±2.7)h；术后住院时间分别为(12.4±3.6)、(8.2±4.1)d,频繁过量应用抗菌药物等,均是术后手术部位感染的易感因素,组间比较差异均有统计学意义(P＜0.05).结论 临床在对普通外科患者进行手术治疗时,应综合考虑患者因素、治疗因素,采取针对性的防感染措施,以降低患者术后手术部位的感染发生率.

Analysis of risk factors for surgical site infections and preventive countermeasures for general surgical patients after surgery

OBJECTIVE By studying the risk factors for surgical site infections in general surgical patients after surgery,to explore the methods for prevention of surgical site infections.METHODS A total of 462 patients admitted to surgical treatment in the general surgery department from Jan.2010 to Jan.2011 were chosen as the research objects.They were divided into the surgical site infection group and the normal group based on the present or absent of surgical site infections.Their general information and treatment data were analyzed.The risk factors for postoperative surgical site infections were summarized to explore specific measures to prevent surgical site infections.RESULTS Among 462 patients,postoperative surgical site infections occurred in 43 patients,and the rate was 9.3%.Comparative analysis between two groups showed that aging,obesity,diabetes mellitus,emergency surgery,pollution types of surgery,operative time greater than 4 hours,postoperative hospital stay longer than 10 days,and frequent excessive use of antibiotics were the risk factors for postoperative surgical site infections.The difference of factors between the two groups were significant(P<0.05).CONCLUSION Patient factors and treatment factors should be taken into consideration for treatment in the surgical treatment,and appropriate infection control measures should be taken to reduce postoperative surgical site infection rate.