甲状腺次全切除术术后感染相关因素分析

发布时间：2018-06-20 20:31

本文选题：甲状腺手术 + 术后感染　；参考：《中华医院感染学杂志》2017年09期

【摘要】：目的探讨甲状腺次全切除术后切口感染相关因素及解决方案。方法对2014年1月-2016年6月医院治疗的480例甲状腺手术患者的临床资料进行回顾性研究,总结甲状腺次全切除术后切口感染的可能因素,采用logistic回归分析对可能因素进行分析,找出与甲状腺手术切口感染密切相关的危险因素,并对切口感染的预防及治疗进行探讨。结果 480例接受甲状腺手术患者发生感染34例,感染率为7.08%;单因素分析结果显示,年龄、手术时间、基础疾病、切口长度与甲状腺次全切除术后切口感染的发生具有相关性(P0.05);多因素logistic回归分析结果显示,年龄50岁、手术时间2h、有基础疾病、切口长度5cm是甲状腺次全切除术后切口感染的独立危险因素;预防使用抗菌药物的患者其感染率(7.69%)远低于未预防使用抗菌药物患者(34.04%),差异有统计学意义(P0.05)。结论甲状腺手术后切口感染的主要因素为高龄、手术时间2h、有基础疾病、切口长度5cm、未预防性使用抗菌药物;通过加大医疗器械的消毒力度,提高手术室无菌等级,恰当的评估患者身体水平及危险因素,合理、安全、主动、预防性的运用抗菌药物,可有效降低术后切口感染。
[Abstract]:Objective To explore the factors and solutions of incision infection after subtotal thyroidectomy . Methods Retrospective study was conducted on clinical data of 480 thyroid patients treated by hospital in January -2016 , 2014 , retrospectively studying the possible factors of incisional infection after subtotal thyroidectomy , logistic regression analysis was used to analyze the risk factors associated with the infection of incision in thyroid surgery , and discuss the prevention and treatment of incision infection . Results The infection of 480 patients with thyroid surgery was 34 cases , and the infection rate was 7.08%; . Single factor analysis showed that the incidence of incision infection was correlated with age , surgical time , basic disease , length of incision and total thyroidectomy . Multiple factors logistic regression analysis showed that the age of 50 , surgical time 2h , basic disease , length of incision 5cm are independent risk factors for incisional infection after subtotal thyroidectomy ; Patients who prevented the use of antibacterial drugs had a (7.69%) infection rate of (7.69%) far lower than that of (34.04%) , a non-preventable antibiotic , with a statistically significant difference of (P0.05) . Conclusion The main factors of incision infection after thyroidectomy are elderly , surgical time 2h , basic disease , incision length 5cm , preventive use of antibiotics ; By increasing the disinfection of medical devices and improving the level of sterile surgery , appropriate assessment of the patient's body level and risk factors , reasonable , safe , active , preventive use of antimicrobial drugs , can effectively reduce postoperative incision infection .
【作者单位】：天津港口医院外科;天津肿瘤医院甲状腺颈部肿瘤科;
【分类号】：R653

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