非局麻乳房清洁切口手术部位感染多中心调查

Multicenter survey of surgical site

摘要:

目的了解非局麻乳房清洁切口手术部位感染（SSI）发病率，评估感染相关危险因素。方法回顾性调查福建省22所医院共3 327例非局麻乳房清洁切口手术病例，分析其SSI情况及相关危险因素。结果3 327例患者，恶性肿瘤者1 502例（45.19%），平均手术时间（101.18±8.04）min；共发生SSI 24例，发病率为0.72%；253例（7.60%）术前预防性使用抗菌药物，62.66%在术前0.5～2 h内使用抗菌药物。主要感染病原菌为金黄色葡萄球菌。对SSI相关危险因素进行单因素和logistic回归分析，结果显示恶性肿瘤、糖尿病、使用免疫抑制剂是SSI的危险因素（均P＜0.05）。结论非局麻乳房清洁切口SSI控制情况较好；同时，临床术前应主动评估患者SSI危险因素，采取综合防控措施降低感染风险。

关键词:

乳房手术; 清洁切口; 医院感染; 手术部位感染; 危险因素; logistic分析

Abstract:

ObjectiveTo investigate the incidence of surgical site infection(SSI) following clean incision breast surgery under nonlocal anesthesia, and evaluate risk factors for SSI.MethodsClinical data of 3 327 patients who underwent clean incision breast surgery under nonlocal anesthesia in 22 hospitals in Fujian Province were surveyed retrospectively, SSI and risk factors were analyzed.ResultsAmong 3 327 patients, 1 502（45.19%）were with malignant tumors, the average duration of surgery were （101.18±8.04）minutes; a total of 24 cases of SSI occurred, incidence of SSI was 0.72%；253（7.60%）patients received preoperative antimicrobial prophylaxis, 62.66% used antimicrobial agents within 0.5-2 hours before surgery. The main pathogenic bacteria was Staphylococcus aureus. Univariate and logistic regression analysis revealed that malignant tumor, diabetes mellitus,and use of immunosuppressants were all risk factors for SSI (all P＜0.05).ConclusionSSI following clean incision breast surgery under nonlocal anesthesia is well controlled, risk factors for SSI should be evaluated before operation, comprehensive preventive measures should be taken to reduce the incidence of SSI.

Key words:

breast surgery; clean incision; healthcareassociated infection; surgical site infection; risk factor; logistic analysis