5例手术部位感染调查

Surgical site infection in five patients

摘要:

目的分析某院短期内神经外科多例患者手术部位感染(SSI)的可能原因。方法收集该院2013年2月1日—3月15日135例神经外科手术患者资料，采用病例对照研究，回顾性分析可能引起SSI的危险因素。结果135例手术患者，5例发生SSI，感染率为3.70%。病例对照研究显示，第5手术间使用情况和进行二次手术的比值比分别为4.07（95%CI：0.52~36.65）、18.00（95%CI：2.00~180.00）。各手术主刀医生施行手术患者SSI率与该科2012年平均SSI率2.54%（17/669）比较，差异均无统计学意义（均P>0.05）。第5手术间环境卫生学检测，除麻醉机袖带的菌落总数超标外，其余采样部位单位面积菌落总数均符合国家要求；且麻醉机袖带采样培养的微生物为凝固酶阴性葡萄球菌，与感染患者致病微生物无关。结论进行二次手术是此次短期多例神经外科患者发生SSI的高危因素。

Abstract:

ObjectiveTo investigate the possible causes of surgical site infection（SSI）in neurosurgical patients in a hospital during a short period of time. MethodsMedical data of 135 neurosurgical operative patients from February 1 to March 15, 2013 were reviewed,the possible risk factors for SSI  were analyzed retrospectively with casecontrol study. ResultsOf 135 operative neurosurgical patients, 5 (3.70%) developed SSI. Casecontrol study showed that the ratio of the run of the fifth operating room and undergoing of secondary  operation was 4.07 (95%CI: 0.52-36.65) and 18.00（95%CI：2.00-180.00）respectively. The difference between each surgeon special SSI rate and the average SSI rate in 2012 （2.54%［17/669］） was not significantly different (P>0.05). Bacterial detection of environmental specimens of the fifth operating room showed that except anesthetic cuff exceeded standard, the others were met the national requirements, and the isolated bacteria from anesthetic cuff was coagulase negative Staphylococcus, which was not related with pathogens in infection. Conclusion“The secondary surgery” is the key risk factor for SSI of neurosurgical patients.