阑尾切除术手术部位感染危险因素研究

Risk factors for surgical site infections after appendectomy

摘要:

目的探讨阑尾切除术手术部位感染的危险因素，为制定感染控制措施提供依据。方法对某院2010年8月—2011年12月施行阑尾切除术的512例患者资料进行调查。结果512例患者发生手术部位感染42例，感染率8.20%，均为表浅手术切口感染。单因素分析结果显示，患者年龄、皮下组织厚度、是否患糖尿病、麻醉类型、手术持续时间、手术季节、手术切口类型、阑尾病理类型等与手术部位感染相关（均P＜0.05）。多因素Logistic回归分析结果显示，手术切口类型(OR 95%CI: 2.75～67.45)、皮下组织厚度(OR 95%CI: 4.54～45.81)、是否患糖尿病(OR 95%CI: 5.13～29.91)、麻醉类型(OR 95%CI: 1.79～53.28)、手术持续时间(OR 95%CI: 8.10～78.63)及阑尾病理类型(OR 95%CI:5.51～54.74)是患者手术部位感染的危险因素（均P＜0.05）。结论应针对手术部位感染危险因素重点防控，预防阑尾切除术后手术部位感染的发生。

Abstract:

ObjectiveTo evaluate risk factors for surgical site infections (SSIs) after appendectomy, and provide reference for developing infection control strategies. MethodsData of 512 patients who received appendectomy between August 2010 and December 2011 were reviewed and analyzed.ResultsFortytwo of 512 patients developed SSIs, infection rate was 8.20%, all were superficial incisional SSIs. Univariate analysis showed that SSIsrelated factors were patients’ age, subcutaneous tissue thickness, diabetes, types of anesthesia, duration of surgery, season of surgery, types of incision, pathology of appendix (all P<0.05). Multivariate Logistic regression analysis showed that the risk factors for SSIs were types of incision(OR 95%CI, 2.75-67.45), subcutaneous tissue thickness(OR 95%CI, 4.54-45.81), diabetes(OR 95%CI, 5.13-29.91), types of anesthesia(OR 95%CI, 1.79-53.28), duration of surgery(OR 95%CI, 8.10-78.63), and pathology of appendix (OR 95%CI:5.51-54.74) (all P<0.05).ConclusionInfection of SSIs should be intensified according to risk factors, so as to prevent the occurrence of SSIs after appendectomy.