鼻内镜手术患者感染的相关因素分析

发布时间：2018-04-15 19:12

本文选题：鼻内镜 + 手术　；参考：《中华医院感染学杂志》2017年12期

【摘要】：目的研究鼻内镜手术患者感染风险因素,旨在降低术后感染率,促进患者早日康复。方法选取2010年9月-2016年8月在医院行鼻内镜手术患者2 934例,回顾性观察患者性别、年龄、基础疾病、疾病分类、吸烟史、肥胖或营养不良、放化疗史、麻醉方法、手术时间、切口类型、术前抗菌药物使用、术后抗菌药物使用时间和住院时间,引入二分类logistic回归模型分析鼻内镜手术感染高危风险因素,研究其相关性。结果 2 934例鼻内镜手术患者,发生感染28例、感染率0.95%,鼻部肿瘤、鼻中隔偏曲患者感染率高于鼻息肉、慢性鼻窦炎患者,且鼻部肿瘤患者感染率高于鼻中隔偏曲患者,差异均有统计学意义(P0.05);基础疾病(糖尿病)、吸烟、肥胖或营养不良、放化疗、麻醉方法、手术时间、切口类型、术前抗菌药物使用和住院时间为患者感染的危险因素;logistic回归模型显示,糖尿病、吸烟史、肥胖或营养不良、放化疗史、麻醉方法、手术时间、切口类型、住院时间是鼻内镜手术者感染的高危独立风险因素,而术前抗菌药物使用是鼻内镜手术感染的唯一保护因素。结论鼻内镜手术患者感染风险因素较多,定期积极筛查鼻内镜手术感染因素,明确风险,早期采取有效措施最大限度控制手术感染,提高手术疗效。
[Abstract]:Objective to study the risk factors of infection in patients undergoing endoscopic sinus surgery.Methods from September 2010 to August 2016, 2 934 patients underwent endoscopic sinus surgery in hospital. Sex, age, basic diseases, disease classification, smoking history, obesity or malnutrition, history of radiotherapy and chemotherapy, anesthetic methods, operation time were retrospectively observed.The type of incision, the use of antibiotics before operation, the time of using antibiotics and the duration of hospitalization after operation were analyzed by using two classification logistic regression model to analyze the risk factors of infection in endoscopic sinus surgery and the correlation between them was studied.Results among the 2 934 patients undergoing endoscopic sinus surgery, 28 cases were infected and the infection rate was 0.95.The infection rate of nasal tumor and nasal septum deviation was higher than that of nasal polyp, chronic sinusitis, and the infection rate of nasal tumor was higher than that of nasal septum deviation.The differences were statistically significant (P 0.05). Basic diseases (diabetes mellitus, smoking, obesity or malnutrition, radiotherapy and chemotherapy, anaesthesia, operative time, incision type),Logistic regression model showed that diabetes mellitus, smoking history, obesity or malnutrition, history of radiotherapy and chemotherapy, anesthetic method, operation time, incision type were the risk factors of infection.The duration of hospitalization is a high risk factor for infection in patients undergoing endoscopic sinus surgery, and the use of antibiotics before operation is the only protective factor for infection in endoscopic sinus surgery.Conclusion there are many risk factors of infection in patients undergoing endoscopic sinus surgery. The infection factors of endoscopic surgery are screened regularly and the risk is identified. Effective measures should be taken to control the infection in the early stage and to improve the curative effect.
【作者单位】：河南省人民医院耳鼻喉科;
【分类号】：R765.9

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