产妇行椎管内麻醉剖宫产医院感染病原菌分布与相关因素分析

发布时间：2018-02-04 22:29

本文关键词： 椎管内麻醉剖宫产医院感染危险因素　出处：《中华医院感染学杂志》2015年12期 　论文类型：期刊论文

【摘要】：目的探讨产妇行椎管内麻醉剖宫产手术后医院感染及相关危险因素,为降低剖宫产产妇术后感染率提供依据。方法选择2013年10月-2014年9月收治的1 035例行椎管内麻醉剖宫产产妇为研究对象,对术后发生医院感染的60例产妇感染部位及病原菌分布进行分析。结果 1 035例行椎管内麻醉剖宫产产妇术后感染60例,感染率为5.80%;产妇感染部位主要为手术切口、呼吸道、生殖道及泌尿道,分别占48.33%、25.00%、16.67%及10.00%;共分离出107株病原菌,其中革兰阳性菌51株占47.66%、革兰阴性菌56株占52.34%;logistic回归分析发现胎膜早破、侵入性检查、术中出血量、并发症、手术时间是术后医院感染的独立危险因素(P0.05)。结论行椎管内麻醉剖宫产产妇术后感染的危险因素较多,应采取措施尽量缩短手术时间、减少组织损伤及术中出血量,合理预防性应用抗菌药物,以降低剖宫产产妇医院感染率。
[Abstract]:Objective to investigate the nosocomial infection and its related risk factors in parturient after cesarean section under intraspinal anesthesia. Methods 1 035 cases of intrathecal anesthesia cesarean section from October 2013 to September 2014 were selected as the study objects. The location of infection and the distribution of pathogenic bacteria in 60 cases of post-operative nosocomial infection were analyzed. Results the infection rate was 5.80 in 1 035 cases of postpartum infection after cesarean section under intraspinal anesthesia. The main sites of infection were surgical incision, respiratory tract, genital tract and urinary tract, accounting for 48.3325.00% and 10.00% respectively. A total of 107 pathogenic bacteria were isolated, of which 51 were Gram-positive bacteria (47.66) and 56 Gram-negative bacteria (52.34). Logistic regression analysis showed premature rupture of membranes, invasive examination, intraoperative blood loss and complications. Operation time is an independent risk factor of postoperative nosocomial infection (P 0.05). Conclusion there are many risk factors for post-operative infection of cesarean section women undergoing spinal canal anesthesia, and measures should be taken to shorten the operation time as far as possible. In order to reduce the nosocomial infection rate of cesarean section parturient, the tissue injury and intraoperative bleeding were reduced, and the rational prophylactic application of antimicrobial agents was made.
【作者单位】：杭州市余杭区妇幼保健院麻醉科;浙江省人民医院麻醉科;
【基金】：国家青年自然科学基金资助项目(81300052)
【分类号】：R614
【正文快照】： 剖宫产术是产科领域中的重要手术,随着输血、输液、麻醉学、水电解质平衡知识以及手术缝合材料、手术方式改进及控制感染等措施的进步,剖宫产已成为解决难产、产科合并症、挽救产妇及围产儿的有效方法[1-2]。临床应用剖宫产的比例逐渐升高,在剖宫产手术过程中多采用椎管内麻醉

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