剖宫产术后切口感染病原学特点及其危险因素分析

发布时间：2018-03-28 03:19

本文选题：剖宫产术　切入点：切口感染　出处：《中华医院感染学杂志》2017年21期

【摘要】：目的研究剖宫产术后切口感染病原学特点及其危险因素分析。方法选取2015年1月-2016年1月医院收治的321例产妇,收集所有患者的临床资料,分析剖宫产术后切口感染率、病原学特点及其发生的相关危险因素。结果剖宫产患者术后发生切口感染83例,感染率25.86%;83例切口感染患者血培养出病原菌98株,革兰阴性菌43株、占43.88%,革兰阳性菌50株、占51.02%,真菌5株、占5.10%;大肠埃希菌对左氧氟沙星、美罗培南、头孢哌酮/舒巴坦、头孢西丁以及诺氟沙星具有较强敏感性,而对阿莫西林、磺胺甲VA唑/甲氧倫啶具有较强耐药性;屎肠球菌及粪肠球菌对左氧氟沙星、头孢哌酮/舒巴坦、美罗培南、头孢西丁具有较强敏感性,而对阿莫西林、头孢曲松、磺胺甲VA唑/甲氧倫啶具有较强耐药性;单因素分析显示患者的年龄、术中出血量、手术时间、肥胖、妊娠伴合并症、留置尿管时间、术前导尿为影响剖宫产术后发生切口感染发生的相关因素;通过logistic分析,年龄、术中出血量、手术时间、肥胖、妊娠伴合并症、留置尿管时间、术前导尿及胎膜早破均是剖宫产术后发生切口感染的独立危险因素。结论导致剖宫产术后发生切口感染的因素很多,临床上需及时关注孕妇潜在的危险因素,及时行个体化防护,并尽量减少手术时间、控制术中出血量、严控术前导尿及留置尿管时间等,从而减少切口感染的发生。
[Abstract]:Objective to study the etiological characteristics and risk factors of incision infection after cesarean section. Methods 321 pregnant women admitted to hospital from January 2015 to January 2016 were selected and the clinical data of all patients were collected and the infection rate of incision after cesarean section was analyzed. Results 83 cases of incision infection occurred after cesarean section, and the infection rate was 25.86 cases. 98 strains of pathogenic bacteria, 43 strains of Gram-negative bacteria, 50 strains of Gram-positive bacteria were isolated from blood of 83 cases of incision infection. Escherichia coli was sensitive to levofloxacin, meropenem, cefoperazone / sulbactam, cefoxitin and norfloxacin, but was sensitive to amoxicillin, while Escherichia coli was sensitive to levofloxacin, meropenem, cefoperazone / sulbactam, and norfloxacin. S. faecium and Enterococcus faecalis were sensitive to levofloxacin, cefoperazone / sulbactam, meropenem and cefxitin, but to amoxicillin and ceftriaxone. Single factor analysis showed age, intraoperative bleeding, time of operation, obesity, complications of pregnancy, time of indwelling urethral catheterization, and other factors, such as the age of patients, the amount of intraoperative bleeding, the time of operation, obesity, pregnancy with complications, and the time of indwelling urethral catheter. Logistic analysis, age, intraoperative bleeding volume, operative time, obesity, pregnancy complicated with complications, indwelling urinary catheter time, were related to the incidence of incisional infection after cesarean section. Preoperative catheterization and premature rupture of membranes are independent risk factors for incision infection after cesarean section. Conclusion there are many factors leading to incision infection after cesarean section. Individualized protection should be carried out in time, operation time should be reduced as far as possible, blood loss during operation should be controlled, and the time of catheterization and indwelling urethral catheter should be strictly controlled so as to reduce the incidence of incision infection.
【作者单位】：杭州市红十字会医院妇产科;
【分类号】：R719.8

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