宫腔镜手术后患者医院感染的危险因素分析

发布时间：2018-06-25 02:47

本文选题：宫腔镜手术 + 医院感染　；参考：《中华医院感染学杂志》2015年10期

【摘要】：目的探讨宫腔镜手术后患者合并医院感染及相关因素,为降低宫腔镜术后医院感染的发生提供依据。方法选取2009年1月-2014年11月医院89 037例行宫腔镜手术治疗患者,对术后发生医院感染患者的临床资料进行统计分析,分析其感染特点及其相关危险因素、主要致病菌,探讨预防医院感染的有效方法及护理措施。结果 89 037例宫腔镜手术患者术后感染88例,感染率为0.10%,感染类型以子宫内膜炎为主,占69.32%,其次为子宫肌内膜炎和盆腔炎,分别占15.91%和7.95%;共检出病原菌150株,前4位病原菌依次为链球菌属、大肠埃希菌、葡萄球菌属、肠球菌属,分别占30.67%、22.00%、16.67%、14.00%;宫腔镜手术后患者年龄、体质量指数、手术时间、手术等级、子宫大小、术前炎症、预防应用抗菌药物为宫腔镜手术后患者医院感染相关因素(P0.05)。结论导致宫腔镜手术后医院感染相关危险因素较多,患者伴有合并症、术前存在炎症、手术等级高及子宫肌壁的损伤严重均提高了宫腔镜手术后医院感染率,在治疗护理过程中应严格控制无菌,加强器械消毒,预防性使用抗菌药物,以便预防或降低医院感染的发生率。
[Abstract]:Objective to investigate the nosocomial infection after hysteroscopic surgery and its related factors, and to provide evidence for reducing nosocomial infection after hysteroscopy. Methods from January 2009 to November 2014, 89,037 patients undergoing hysteroscopic surgery were selected, and the clinical data of patients with nosocomial infection after operation were statistically analyzed, and the infection characteristics and related risk factors were analyzed, and the main pathogenic bacteria were analyzed. To explore the effective methods and nursing measures to prevent nosocomial infection. Results 88 cases (0.10%) were infected after hysteroscopic surgery. The main type of infection was endometritis (69.32%), followed by endometritis (15.91%) and pelvic inflammatory disease (7.95%), 150 strains of pathogenic bacteria were detected. The first four pathogenic bacteria were Streptococcus, Escherichia coli, Staphylococcus, Enterococcus, respectively, which accounted for 30.670.00 and 16.677.00. The age, body mass index, operative time, surgical grade, uterine size, preoperative inflammation, and posthysteroscopic operation of the patients were all higher than that of the control group, and the first four pathogens were Streptococcus, Escherichia coli, Staphylococcus and Enterococcus, respectively. Prophylactic use of antimicrobial agents was associated with nosocomial infection after hysteroscopic surgery (P0.05). Conclusion there are many risk factors associated with nosocomial infection after hysteroscopic surgery, with complications, inflammation before operation, high grade of operation and serious injury of uterine muscle wall, all of which increase the nosocomial infection rate after hysteroscopic surgery. In order to prevent or reduce the incidence of nosocomial infection, sterilizing instruments and prophylactic use of antimicrobial agents should be strictly controlled in the course of treatment and nursing.
【作者单位】：首都医科大学附属北京妇产医院计划生育科;
【基金】：国家自然科学基金资助项目(1200320306)
【分类号】：R713

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