摘要
目的探讨心脏直视术后发生医院感染的危险因素及预防对策,为心脏直视术后感染的预防提供参考。方法收集2015年1月-2016年12月在医院行心脏直视术的300例患者临床资料,整理临床资料分析术后感染率及引起感染的相关因素。结果 300例患者术后感染22例,感染率为7.33%,其中切口浅表感染11例、切口深部感染6例、导管相关性感染4例、纵膈感染1例,分别占50.00%、27.27%、18.18%、4.55%;22例感染患者局部分泌物共检出病原菌22株,以革兰阴性菌14株为主,占63.64%;合并糖尿病、手术时间>2h、术后ICU住院时间>2d、有外物置入时为术后感染的相关危险因素(P<0.05);多因素Logistic回归分析结果显示,合并糖尿病、手术时间>2h、有外物置入是与心脏直视术后发生感染的独立危险因素(P<0.05)。结论心脏直视术后感染主要以手术部位切口浅部感染为主,引起感染的危险因素较多,应针对危险因素进行干预以降低感染的发生。
OBJECTIVE To explore the risk factors for postoperative nosocomial infections in patients undergoing open heart surgery and put forward the prevention countermeasures so as to provide guidance for prevention of the postoperative infections.METHODS The clinical data were collected from 300 patients who underwent the open heart surgery in the hospital from Jan 2015 to Dec 2016.The incidence of postoperative infections and the related factors for the infection were analyzed.RESULTS Of the 300 patients,22 had postoperative infections,with the infection rate 7.22%,of whom 11（50.00%）had superficial incision infections,6（27.27%）had deep incision infections,4（18.18%）had catheter-related infections,and 1（4.55%）had mediastinal infections.A total of 22 strains of pathogens were isolated from local secretions of the 22 patients with the infections,of which 14（63.64%）were gram-negative bacteria.The complication with diabetes mellitus,operation duration more than 2 hours,postoperative ICU stay more than 2 days and implants were the related risk factors for the postoperative infections（P〈0.05）.Multivariate logistic regression analysis indicated that the complication with diabetes mellitus,operation duration more than 2 hours,and implants were the independent risk factors for the postoperative infections in the patients undergoing open heart surgery（P〈0.05）.CONCLUSIONThe patients with superficial incision infections are dominant among the open heart surgery patients with postoperative infections,there are a variety of risk factors for the infections,and it is necessary to take the intervention measures aiming at the risk factors so as to reduce the incidence of infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第21期4927-4930,共4页
Chinese Journal of Nosocomiology
关键词
心脏直视术后
感染
危险因素
预防对策
Open heart surgery
Infection
Risk factors Prevention countermeasure
