摘要
目的研究神经外科发生手术切口感染的独立危险因素和切口感染对医疗费用的影响,为有效预防和控制手术切口感染提供理论依据。方法收集医院神经外科1 604例患者的临床资料,以手术术后切口感染为因变量,以患者年龄、性别、术前住院天数、颅内出血等14项因素为自变量纳入非条件Logistic回归分析模型,统计出神经外科手术切口感染的独立危险因素,并对比切口感染对医疗费用的影响。结果神经外科手术后切口感染的发生率为6.05%。单因素分析结果显示,术前住院天数、肿瘤、急诊手术、围术期输血、手术风险分级等因素差异有统计学意义(P<0.05);多因素分析结果显示,围术期输血和急诊手术是神经外科手术切口感染的独立危险因素(P<0.05)。切口感染组患者的手术治疗费、药品费和住院总费用明显高于非切口感染组(P<0.05)。结论严格落实围术期输血制度的管理,加强医务人员无菌意识,尽量避免急诊手术,完善术前检查和控制急性症状,以减少手术切口感染率和患者的医疗费用。
Objective To investigate the independent risk factors of incision infection of neurosurgical procedures and the effects of incision infection on medical expenses in order to provide theoretical basis for prevention and controlling of incision infection. Methods The clinical data about 1,064 patients who were admitted and treated in department of neurosurgery were collected. Taking incision infection as dependent variable and the 14 factors including patient＇s age,sex,preoperative hospitalization day,intracranial hemorrhage as independent variable,single factor analysis and Logistic regression analysis were used to analyze the risk factors of incision infection after neurosurgical procedures. Moreover the effects of incision infection on medical expenditure were analyzed. Results The incidence rate of incision infection after neurosurgical procedures was 6. 05%. The single factor analysis results showed that the five factors including preoperative hospitalization day,tumour,emergency operation,perioperative blood transfusion and surgery risk classification had statistical significance（ P〈 0. 05）. Logistic regression analysis results showed that perioperative blood transfusion and emergency operation were the risk factors of incision infection after neurosurgical procedures（ P〈 0. 05）. Moreover the operation treatment expenses,drug expenses and the total cost of hospitalization in patients with incision infection were significantly higher than those of patients without incision infection（ P〈 0. 05）. Conclusion It is necessary to implement the management of perioperative blood transfusion system strictly,strengthen sterile awareness of medical staff,avoid emergency operation as much as possible,improve preoperative examination and control acute symptoms in order to reduce the incidence rate of incision infection and the medical fees of patients.
作者
蒙光义
彭评志
庞二友
王冬晓
卢婷
MENG Guangyi;PENG Pingzhi;PANG Eryou(Department of Pharmacy,The First People＇ s Hospital of Yulin City,Guangxi,Yulin 537000,Chin)
出处
《河北医药》
CAS
2018年第12期1788-1791,共4页
Hebei Medical Journal
基金
广西壮族自治区玉林市科技局项目(编号:玉科计字20147011)
关键词
神经外科
切口感染
危险因素
医疗费用
neurosurgery
incision infection
risk factor
medical expenses
