外科手术部位感染现状及危险因素分析

摘要

Objective To analyze the surgical site infection(SSI)status and its risk factors in the department of general surgery. Methods The 1698 cases of hospitalized patients undergoing surgery from June 2014 to December 2016 in our hospital were chosen as research objects,and the one-way and multiple Logisitic analysis were used to record the sex,adverage age,disbetes and other basic diseases, ASA classification and the surgical site infection classification,surgical incision time,blood transfusion,preoperative preventive medication and average operation time index.Results The average age in SSI group was lower than that of group SSI[(62.1 ±13.7)vs(42.7 ± 18.5)],the average operation time in SSI group was lower than that of group SSI[(186.4 ±86.3)min vs(132.7 ±66.7)min](P<0.05).SSI infection rate univariate analysis showed that:patients with diabetes than non -diabetic patients;patients with other underlying diseases;ASA classification,III>II>IV>I;incision classification(P<0.05).However,there was no significant difference between the two groups in the timing of surgery,gender,blood transfusion or not The difference was not statistically significant(P>0.05).Logistic anal-ysis showed that diabetes mellitus,ASA classification and incision classification were independent factors of surgical site infection.Conclu-sion Surgical site infection in the department of general surgery is related to ASA classification,surgical site infection classification and dia-betes,early intervention is in needed for these risk factors.%目的 分析外科手术部位感染(SSI)现状,并对其危险因素进行分析.方法 以2014年1月至2016年12月于重庆市大足区人民医院接受外科手术的1698例患者为研究对象,分为SSI组(66例)和非SSI组(1632例).单因素、多因素logistic回归分析患者SSI情况,筛查性别、年龄、基础疾病、美国麻醉师协会(ASA)分级、切口分类、手术时间、是否输血、术前预防性用药情况等高危因素.结果 SSI 组平均年龄(62.1 ±13.7)岁,平均手术时间(186.4 ±86.3)min,高于非SSI 组的(42.7 ±18.5)岁和(132.7 ±66.7)min,差异均有统计学意义(P<0.05).SSI感染率单因素分析结果显示:糖尿病患者高于无糖尿病患者;有基础疾病患者高于无其他基础疾病患者;ASA分级III级>II级>IV级>I级;切口分类Ⅲ类>Ⅱ类>Ⅰ类;不合理术前预防性应用抗菌药物患者高于术前合理抗菌用药患者,差异均有统计学意义(P<0.05);但手术时机、性别、输血与否之间的差异无统计学意义(P>0.05).多因素logistic回归分析显示,糖尿病、ASA分级和切口分类是SSI发生的独立危险因素.结论 SSI的发生与ASA分级、切口分类及是否有糖尿病有关,应针对上述高危因素给予早期干预.