摘要
目的:分析宫颈癌根治术后患者医院感染的病原菌分布和耐药性及其相关危险因素,为减少医院术后感染提供参考依据。方法:回顾性分析2016年7月~2018年12月230例在我院行宫颈癌根治手术患者的临床资料,调查并统计患者术后医院感染病原菌情况及耐药性,并采用SPSS 19.0软件对其进行单因素和多因素logistic回归分析影响患者术后医院感染的因素。结果:①230例宫颈癌根治术患者,术后发生感染46例,感染率20.00%;感染部位主要为手术切口20例占43.48%,其次为泌尿道12例占26.09%;②46例感染患者中共检出病原菌69株,其中革兰阴性菌39株占56.52%、革兰阳性菌24株占34.78%、真菌6株占8.70%;③主要革兰阴性菌中大肠埃希菌对氨苄西林、头孢呋辛、四环素及左氧氟沙星的耐药率较高,均>80%,铜绿假单胞菌对阿莫西林、磺胺甲噁唑及四环素的耐药性较高,均>70%;主要革兰阳性菌中金黄色葡萄球菌对青霉素G、左氧氟沙星、庆大霉素的耐药率较高,均>60%,粪肠球菌对红霉素、利福平及四环素耐药率较高,均>60%;④对46例的临床资料进行单因素分析发现,患者的年龄、有无糖尿病、导尿次数≥3次、尿管留置时间≥14 d、抗菌药物≥3种、抗菌药物使用时间≥7 d、住院时间≥14 d、手术时间≥3 h、贫血以及接受化疗等是引发感染的危险因素,差异有统计学意义(P<0.05);⑤对有意义的单因素进行多因素logistic回归分析发现,患者的糖尿病、接受化疗、尿管留置时间≥14 d、贫血、抗菌药物≥3种、抗菌药物使用时间≥7 d是导致患者术后发生感染的独立危险因素,差异有统计学意义(P<0.05)。结论:宫颈癌根治术患者医院感染率高,病原菌种类多且耐药性强,临床医师应根据药敏试验结果选择合适的抗菌药物;根据医院感染相关危险因素采取有效预防措施,降低术后感染的发生。
Objective: To analyze the distribution and drug resistance of the pathogenic bacteria and the related risk factors of the hospital infection after radical operation of cervical cancer, and to provide the reference for reducing the post-operative infection of the hospital. Methods: The clinical data of 230 patients with cervical cancer in our hospital from July 2016 to December 2018 were analyzed retrospectively. The single-factor and multi-factor logistic regression analysis was used to analyze the factors of hospital infection after operation. Results:①The infection rate was 20.00% in 46 cases(20.00%)of 230 cases after radical operation of cervical cancer, and the main infection site was surgical incision in 20 cases(43.48%), followed by urinary tract in 12 cases(26.09%).②69 strains of pathogenic bacteria were detected in 46 infected patients, of which 39 strains(56. 52%), 24(34.78%)and 6(8.70%).③The resistance rates of Escherichia coli to ampicillin, cefuroxime, tetracycline and levofloxacin were higher than 80%. Pseudomonas aeruginosa was resistant to amoxicillin, sulfamethoxazole and tetracycline. All of them were more than 70%;The resistant rates of Staphylococcus aureus to penicillin G, levofloxacin and gentamicin were higher than 60%, while those of Enterococcus faecalis to erythromycin, rifampicin and tetracycline were higher than 60%.④Univariate analysis showed that the age, diabetes mellitus, frequency of catheterization ≥3 times, indwelling time of catheter ≥14 days, antibacterials ≥3 kinds, using time of antibiotics ≥7 days and hospitalization time ≥14 days were found in 46 cases. The risk factors of infection were anemia and chemotherapy, the time of operation ≥3 hours, and the difference was statistically significant(P<0.05).⑤Significant univariate logistic regression analysis showed that diabetes mellitus, chemotherapy, indwelling time of catheter ≥14 days, anemia, and antibiotics ≥3 kinds of drugs were found in the patients with diabetes mellitus, who received chemotherap
作者
高望朔
魏岚
霍永生
GAO Wang-shuo;WEI Lan;HUO Yong-sheng(Yijishan hospital, south Anhui medical college, Wuhu, Anhui 241000)
出处
《赣南医学院学报》
2019年第8期800-804,共5页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
关键词
宫颈癌根治术
医院感染
耐药性
危险因素
Radical resection of cervical cancer
hospital infection
tolerance
hazards
