急性化脓性阑尾炎切口感染的危险因素分析及预防对策

目的：分析急性化脓性阑尾炎患者术后切口感染的危险因素，探讨有效的预防对策。方法回顾性分析我院2011年1月～2014年2月间收治的219例急性化脓性阑尾炎患者的临床资料，观察术后切口感染情况，对术后切口感染的危险因素进行分析，总结预防经验。结果本组219例急性化脓性阑尾炎患者，术后切口感染16例，切口感染率为7.3%。经对症处理后，切口达到Ⅱ期愈合。切口感染率在不同年龄、合并基础疾病、术前应用抗生素以及手术时间方面的差异有统计学意义（P＜0.05），而不同性别、切口长度及术后抗生素应用时间方面的差异无统计学意义（P＞0.05）。结论高龄、合并有基础疾病、术前未应用抗生素以及手术时间过长是急性化脓性阑尾炎术后切口感染的危险因素，术前合理应用抗生素，术中合理操作，缩短手术时间，术后加强观察是预防切口感染的关键。

Risk factors analysis and preventative measures of wound infection after surgery of acute suppurative appendicitis

Objective To analyze the risk factors of wound infection after the surgery of acute suppurative appendicitis and explore effective preventive measures. Methods Clinical data of 219 patients with acute suppurative appendicitis admitted to our hospital from January 2011 to February 2014 were analyzed retrospectively and the postoperative wound infection situation was observed. Risk factors of postoperative wound infection were analyzed and preventative experience was summarized. Results Of the 219 patients with acute suppurative appendicitis, 16 patients had postoperative wound infection, with the wound infection rate of 7.3%. After symptomatic treatment, the wound reached stage Ⅱ healing. The wound infection rates were statistically different between different ages, underlying diseases, preoperative application of antibiotics and operative time （P 0.05）. Conclusion Elder age, underlying diseases, absence of preoperative antibiotics and operative time are risk factors of acute suppurative appendicitis. Preoperative rational application of antibiotics, intraoperative rational operation, shortening of operative time and strengthening of postoperative observation are the key to preventing wound infection.