摘要
目的分析全身麻醉下急诊腹部手术老年患者切口感染的病原菌及手术室相关危险因素。方法选取在某院手术室进行的全身麻醉下急诊腹部手术老年患者597例为研究对象,回顾性分析患者术后切口感染的发生情况及病原菌分布情况,对可能影响患者发生切口感染的手术室相关因素进行分析。结果597例全身麻醉下行急诊腹部手术的老年患者有43例(占7.20%)罹患切口感染,分离出55株致病菌,革兰阴性菌、革兰阳性菌和真菌分别有35株(63.64%)、16株(29.09%)和4株(7.27%)。多因素Logistic分析提示,年龄≥70岁、术前系统未完成自净或故障、术中低体温、手术切口Ⅱ或Ⅲ类、手术间空气的菌落数量≥200 cfu/m^(3)以及手术参与人数≥6人等是全身麻醉下急诊腹部手术老年患者切口感染的危险因素(OR>1,P<0.05),而腔镜手术则是保护性因素(OR<1,P<0.05)。结论全身麻醉下急诊腹部手术老年患者切口感染的发生率较高,与多种因素关系密切,主要的致病菌为革兰阴性菌,值得关注。
Objective To analyze the pathogenic bacteria and operating room related risk factors of incision infection in elderly patients undergoing emergency abdominal surgery under general anesthesia.Methods A total of 597 elderly patients undergoing emergency abdominal surgery under general anesthesia in the operating room of our hospital were selected as the research subjects.Retrospectively investigation was used to analyze the incidence of postoperative incision infection,the distribution of pathogenic bacteria in the patients and the operating room related factors that might affect the incidence of incision infection in the patients.Results Among the 597 elderly patients undergoing emergency surgery under general anesthesia,43 patients(7.20%)developed incision infection after surgery,and 55 strains of pathogenic bacteria were isolated,including 35 strains of Gram-negative bacteria(63.64%),16 strains of Gram-positive bacteria(29.09%)and 4 strains of fungi(7.27%),respectively.Multiple Logistic analysis suggested age≥70 years old,incomplete self-purification or malfunction of preoperative system,intraoperative hypotemperature,typeⅡorⅢincision,the number of colonies in the air of the operating room≥200 cfu/m^(3) and number of surgical participants≥6 were risk factors for incision infection in elderly patients undergoing emergency surgery under general anesthesia(OR>1,P<0.05),while endoscopic surgery was a protective factor(OR<1,P<0.05).Conclusion The incidence of incision infection in elderly patients undergoing emergency abdominal surgery under general anesthesia is high,which is closely related to a variety of factors.The main pathogenic bacteria are Gram-negative bacteria,which should be paid attention to.
作者
冯英
王美珍
李超羽
马玲平
FENG Ying;WANG Mei-zhen;LI Chao-yu;MA Ling-ping(Taizhou hospital of Zhejiang province,Taizhou Zhejiang 317000,China)
出处
《中国消毒学杂志》
CAS
2021年第10期754-756,760,共4页
Chinese Journal of Disinfection
关键词
全身麻醉
急诊手术
老年患者
切口感染
病原菌
危险因素
general anesthesia
emergency surgery
elderly patients
incision infection
pathogenic bacteria
risk factors
作者简介
冯英(1986-),女,浙江临海人,本科,护师,从事手术室医院感染防控及护理工作;通信作者:马玲平,E-mail:fengying2020@aliyun.com。
