自动痔疮套扎术治疗混合痔术后发生医院感染的病原菌特点与危险因素分析

发布时间：2018-05-17 11:02

本文选题：RPH + 混合痔　；参考：《中华医院感染学杂志》2017年02期

【摘要】：目的探究自动痔疮套扎术(RPH)治疗混合痔术后医院感染的病原菌特点及高危因素,为临床防治提供指导。方法选取医院2014年2月-2016年2月收治的450例混合痔RPH术后患者为研究对象,其中术后发生医院感染的25例为试验组,其余为对照组,对其进行感染危险因素分析,并对感染患者的致病菌进行药敏分析。结果 25例出现感染的患者脓性分泌物共培养出致病菌58株,其中革兰阳性菌16株,革兰阴性菌40株,真菌2株,革兰阳性菌普遍对克林霉素、红霉素、万古霉素等具有较强敏感性,革兰阴性菌对头孢类药物具有较强敏感性;患者的年龄、体质量指数、有无高血压、有无糖尿病、混合痔严重程度、手术时间均是导致RPH术后感染的危险因素。通过logistic分析,年龄、体质量指数、有无高血压、有无糖尿病、混合痔严重程度均为RPH术后感染的独立危险因素(P0.05)。结论年龄、体质量指数、高血压、糖尿病、混合痔严重程度均是导致混合痔RPH术后发生医院感染的独立危险因素;致病菌以革兰阴性菌为主,且耐药性较强,因此,在感染发生后应当立即进行病原分析和药敏分析,针对性地使用抗菌药物,避免严重后果。
[Abstract]:Objective to investigate the characteristics and high risk factors of nosocomial infection in the treatment of mixed hemorrhoids with automatic hemorrhoids ligation (RPH), so as to provide guidance for clinical prevention and treatment. Methods from February 2014 to February 2016, 450 patients with mixed hemorrhoids after RPH operation were selected as study subjects. 25 patients with nosocomial infection after operation were selected as experimental group and the rest as control group. The risk factors of infection were analyzed. Drug sensitivity analysis of pathogenic bacteria in infected patients was carried out. Results A total of 58 strains of pathogenic bacteria were isolated from purulent secretions of 25 infected patients, including 16 Gram-positive bacteria, 40 Gram-negative bacteria, 2 fungi, and Gram-positive bacteria against clindamycin and erythromycin. Vancomycin and so on have a strong sensitivity, Gram-negative bacteria have a strong sensitivity to cephalosporins, patients' age, body mass index, hypertension, diabetes, mixed hemorrhoids severity, The time of operation was the risk factor of infection after RPH. By logistic analysis, age, body mass index, hypertension, diabetes and the severity of mixed hemorrhoids were all independent risk factors for infection after RPH. Conclusion Age, body mass index, hypertension, diabetes mellitus and the severity of mixed hemorrhoids are independent risk factors for nosocomial infection after mixed hemorrhoids RPH, Gram-negative bacteria are the main pathogens, and drug resistance is strong. Pathogen analysis and drug sensitivity analysis should be carried out immediately after infection, and antimicrobial agents should be used pertinently to avoid serious consequences.
【作者单位】：郑州人民医院肛肠外科;
【基金】：河南省自然科学基金项目(523021432)
【分类号】：R657.18

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