肝胆外科开腹手术患者医院感染相关因素研究

发布时间：2018-02-12 23:12

本文关键词： 肝胆外科开腹手术医院感染部位病原菌分布感染相关指标　出处：《中华医院感染学杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的研究肝胆外科开腹手术患者医院感染的相关因素,以期掌握患者医院感染部位、病原菌种类等分布特点、耐药性及感染相关指标等,从而降低医院感染率、促进患者早日康复。方法选取2015年7月-2016年8月医院肝胆外科开腹手术发生医院感染45例患者为观察组,并选取同期开腹手术未发生感染45例患者为对照组,统计观察组患者感染部位及病原菌分布,并比较两组机体感染相关指标表达情况,同时比较观察组中不同感染部位者的检测结果。结果观察组患者感染部位以手术切口为主占60.00%,其次为肺部、泌尿系、消化道及其他感染,分别占22.22%、8.90%、4.44%及4.44%;观察组患者共分离出病原菌47株,其中革兰阴性菌37株占78.72%,革兰阳性菌10株占21.28%,主要革兰阴性菌为大肠埃希菌及肺炎克雷伯菌,主要革兰阳性菌为金黄色葡萄球菌;同时观察组机体感染相关指标血清降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)及白细胞介素-8(IL-8)表达水平明显高于对照组,且观察组中不同感染部位者检测结果也存在明显差异,差异有统计学意义(P0.05)。结论肝胆外科开腹手术患者医院感染部位以手术切口为主,病原菌以革兰阴性菌为主,同时该类患者机体感染相关指标也呈现高表达状态,故应加强对该类患者的监测与干预。
[Abstract]:Objective to study the related factors of nosocomial infection in patients undergoing hepatobiliary surgery in order to understand the distribution of nosocomial infection site, pathogenic bacteria species, drug resistance and infection related indexes, so as to reduce the nosocomial infection rate. Methods from July 2015 to August 2016, 45 patients with nosocomial infection in hepatobiliary surgery were selected as the observation group, and 45 patients with no infection in the same period were selected as the control group. The location of infection and the distribution of pathogenic bacteria in the observation group were statistically analyzed, and the expression of related indexes of infection in the two groups were compared. Results in the observation group, surgical incision was the main site of infection, followed by lung, urinary tract, digestive tract and other infections. In the observation group, 47 strains of pathogenic bacteria were isolated, of which 37 strains were Gram-negative bacteria (78.72%), 10 Gram-positive bacteria (21.28%), and the main Gram-negative bacteria were Escherichia coli and Klebsiella pneumoniae, the main gram-negative bacteria were Escherichia coli and Klebsiella pneumoniae. The main gram-positive bacteria were Staphylococcus aureus, and the expression levels of serum procalcitonin (PCT), hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and interleukin-8IL-8 (IL-8) were significantly higher in the observation group than in the control group. There were also significant differences in the results of different infection sites in the observation group (P 0.05). Conclusion the nosocomial infection site of patients undergoing hepatobiliary surgery is mainly surgical incision, and the main pathogenic bacteria are Gram-negative bacteria. At the same time, the related indicators of infection also showed high expression, so we should strengthen the monitoring and intervention of this kind of patients.
【作者单位】：郑州大学附属医院南阳市中心医院胆道普外科;南阳医学高等专科学校;
【基金】：河南省基础与前沿技术研究项目(103422511320)
【分类号】：R656

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