经口寰枢椎复位内固定患者术后医院感染危险因素分析及对策

发布时间：2019-06-02 16:33

【摘要】：目的分析经口寰枢椎复位内固定(TARP)手术患者医院感染的危险因素及其对预后的影响,提出临床管理对策。方法选取医院2013年7月1日-2015年6月30日行TARP手术患者121例,分析术后感染率及感染的相关因素。结果 121例TARP手术患者术后发生医院感染20例,感染率为16.53%,感染22例次,例次感染率为18.18%;感染部位以呼吸系统、泌尿系统和手术部位为主,其中下呼吸道感染9例次,占40.91%,泌尿道感染5例次,占22.73%,手术部位4例次,占18.18%;单因素分析有统计学意义的危险因素包括住院时间、手术时间、术中输血量、术中输液量、使用呼吸机、合并基础疾病、口腔疾病、术后发热38℃、多次入住ICU及院内获得多药耐药菌;二分类logistics回归分析显示,使用呼吸机、院内获得多药耐药菌、口腔疾病及术中输液量是TARP手术患者发生医院感染的独立危险因素。结论 TARP手术患者医院感染危险因素较多,应针对各种危险因素积极采取预防控制措施,尤其应注意呼吸机管理、多药耐药菌管理、口腔护理及控制术中输液量,以减少医院感染,提高治愈率。
[Abstract]:Objective to analyze the risk factors of hospital infection and its influence on prognosis in patients undergoing oral atlantoaxial reduction and internal fixation with (TARP), and to put forward clinical management countermeasures. Methods from July 1, 2013 to June 30, 2015, 121 patients underwent TARP operation in our hospital. The infection rate and related factors were analyzed. Results there were 20 cases of hospital infection, the infection rate was 16.53%, 22 cases were infected, and the infection rate was 18.18%. Respiratory system, urinary system and surgical site were the main sites of infection, including 9 cases of lower respiratory tract infection (40.91%), 5 cases of urinary tract infection (22.73%) and 4 cases of operation site (18.18%). Univariate analysis showed that statistically significant risk factors included hospitalization time, operation time, intraoperative blood transfusion, intraoperative infusion, use of ventilator, combined with basic diseases, oral diseases, postoperative fever at 38 鈩，

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