剖宫产手术切口感染的监测及临床干预分析

摘要

Objective:To analyze the risk factors of operation incision infection after cesarean section,using clinical intervention to control wound infection,and to improve the quality of medical service.Methods:From January 2014 to June 2014,we monitored the operation details of cesarean section in the obstetrician,investigated the risk factors of operation incision infection after cesarean section,and collected pathogen data of patients with incision infection.According to the survey results,to circumvent the risk factors,cesarean section parturients were given clinical intervention for prevention of incision infection from July 2014 to the present.Results:From January 2014 to June 2014,288 cases had cesarean section,23 cases had incision infection,the infection rate was 7.78%.The survey found that irregular operation,long operation time were major risk factors in patients with incision infection, obesity,uterine scar,premature rupture of membranes,anemia were also objective risk factors.Inspection results of pathogenic bacteria showed that staphylococcus aureus,staphylococcus aureus and escherichia coli were the main pathogen.According to the survey results,clinical intervention measures were carried out,since 2014 July,216 cases had cesarean section operation,5 cases had incision infection,the infection rate was 2.31%.Before and after clinical intervention,cesarean section incision infection status had significant difference(P＜0.05).Conclusion:Standard operation operation was the key to preventing the infection of incision,at the same time,we should pay attention to other risk factors for operation incision infection,and take effective measures to prevent operation incision infection.%目的:分析剖宫产手术切口感染的危险因素,临床干预控制手术切口感染,提高医护质量.方法:2014年1-6月监测产科医师剖宫产的手术操作细节,调查剖宫产手术切口感染的危险因素,收集剖宫产手术切口感染患者的病原学资料.根据调查结果,规避危险因素,对2014年7月以后的剖宫产产妇实施预防切口感染的临床干预.结果:2014年1-6月剖宫产合计288例,手术切口感染23例,感染率7.78%.调查发现医师的操作不规范、手术时间过长是切口感染的主观危险因素,患者肥胖、瘢痕子宫、胎膜早破、贫血是客观的危险因素.病原菌检查发现金黄色葡萄球菌、表皮葡萄球菌和大肠埃希菌是主要病原菌.根据调查结果,实施临床干预措施,2014年7月以后的剖宫产产妇合计216例,手术切口感染5例,感染率2.31%.临床干预前后,剖宫产手术切口感染状况差异有统计学意义(P＜0.05).结论:规范化的手术操作是预防手术切口感染的关键,同时要重视手术切口感染的其他危险因素,采取有效措施防治手术切口感染.