胆囊切除患者术后医院感染的危险因素分析及预防对策研究

发布时间：2019-08-09 07:27

【摘要】：目的探讨胆囊切除患者术后医院感染的危险因素及有效的预防策略,以降低医院感染率。方法选取医院2015年1月-2016年3月行胆囊切除术的住院患者200例,观察患者的各项自身指标和手术相关指标,统计患者术后医院感染率,并对术后感染患者进行病原学检测,分析导致患者发生医院感染的危险因素并探讨可行的预防措施。结果 200例胆囊切除术患者中13例术后发生感染,感染率6.50%;病原学检测结果显示,在感染患者分泌物中共培养出病原菌46株,其中革兰阳性菌16株,革兰阴性菌27株,真菌3株,分别占34.78%、58.70%及6.52%;患者的年龄、性别等各项自身指标及术中出血量、围术期抗菌药物使用时间等因素与是否发生术后感染无明显相关性,但手术时间90min、开腹手术、急诊手术、术中进行胆总管探查和发生胆囊破裂为术后感染发生的危险因素;多因素回归分析结果显示,手术时间、手术方式、手术时机及手术中进行胆总管探查和发生胆囊破裂均为患者术后感染发生的独立危险因素。结论胆囊切除患者发生术后感染的因素主要为手术时间过长、开腹手术、急诊手术、术中进行胆总管探查和发生胆囊破裂,患者自身因素对感染的发生影响较小,临床上可在术中针对相关危险因素进行预防,降低医院感染率。
[Abstract]:Objective to investigate the risk factors and effective prevention strategies of hospital infection in patients with gallbladder resection in order to reduce the hospital infection rate. Methods 200 inpatients undergoing Cholecystectomy from January 2015 to March 2016 were selected to observe their own indexes and related indexes, to count the postoperative hospital infection rate, and to detect the etiology of the patients with postoperative infection. The risk factors leading to hospital infection were analyzed and the feasible preventive measures were discussed. Results the infection rate was 6.50% (13 / 200). The results of etiological examination showed that 46 strains of pathogenic bacteria were cultured in the secretions of infected patients, including 16 strains of Gram-positive bacteria, 27 strains of Gram-negative bacteria and 3 strains of fungi, accounting for 34.78%, 58.70% and 6.52%, respectively. the results showed that 46 strains of pathogenic bacteria were cultured in the secretions of infected patients, including 16 Gram-positive bacteria, 27 Gram-negative bacteria and 3 fungi. There was no significant correlation between age, sex, intraoperative blood loss, perioperative antibiotic use time and postoperative infection, but 90 minutes of operation, open surgery, emergency operation, intraoperative common bile duct exploration and gallbladder rupture were the risk factors of postoperative infection. The results of multivariate regression analysis showed that the time of operation, the mode of operation, the timing of operation, the exploration of common bile duct and the occurrence of gallbladder rupture were independent risk factors for postoperative infection. Conclusion the main factors of postoperative infection in patients with gallbladder resection are too long operation time, open operation, emergency operation, common bile duct exploration and gallbladder rupture during operation. The patient's own factors have little influence on the occurrence of infection. The related risk factors can be prevented during operation and the hospital infection rate can be reduced.
【作者单位】：郑州大学第五附属医院消毒供应中心;
【基金】：河南省卫计委科研基金资助项目(201304028)
【分类号】：R657.4;R197.323

【相似文献】