摘要:
目的 分析高龄产妇剖宫产术后切口感染的危险因素,为预防感染提供科学指导。方法 选取2018年1-10月郑州市妇幼保健院接收的237例高龄剖宫产产妇作为研究对象,进行回顾性分析。按照是否发生术后切口感染分为感染组(28例)、非感染组(209例),对比两组产妇一般资料及剖宫产相关情况,并进行Logistic回归分析,确定术后切口感染的危险因素。结果 28例产妇发生术后切口感染,共分离出31株菌株,其中革兰阴性菌占77.42%(24/31);革兰阳性菌占22.58%(7/31)。感染组产妇高血压、糖尿病、夏季手术、胎膜早破百分比明显高于非感染组,BMI、备皮至手术时间、阴道检查次数、术中出血量、手术时间数据均高于非感染组,对比差异有统计学意义(P<0.05)。提示,上述因素是术后切口感染的单一危险因素。以术后切口感染为因变量,以组间对比差异有统计学意义的指标作为自变量,建立Logistic回归方程,进行多因素回归分析,证实上述指标均是高龄产妇剖宫产术后切口感染的独立危险因素(均P<0.05)。结论 高龄产妇剖宫产术后切口感染危险因素众多,应尤其注意伴有高血压和糖尿病基础疾病、夏季剖宫产、胎膜早破、BMI高、备皮至手术时间长、阴道检查次数多、术中出血量多、手术时间长的产妇,积极采取预防性干预措施,预防术后切口感染的发生。
Abstract:
Objective To analyze the risk factors of incision infection after cesarean section in elderly women, so as to provide scientific guidance for preventing infection.Methods A total of 237 cases of elderly pregnant women with cesarean section were selected in our hospital from January to October in 2018 as the research objects. Retrospective analysis was used. According to the occurrence of incision infection after operation, the patients were divided into infection group (28 cases) and non-infection group (209 cases). The general information of parturients and the related situation of cesarean section were compared between the two groups.Logistic regression analysis was used to determine the risk factors of incision infection after operation.Results Thirty-one strains were isolated from 28 parturients with incision infection, of which 77.42% (24/31) were Gram-negative bacteria and 22.58% (7/31) were Gram-positive bacteria. The percentages of maternal hypertension, diabetes mellitus, operation in summer and premature rupture of membranes in the infected group were significantly higher than those in the non-infected group. BMI, skin preparation to operation time, number of vaginal examinations, intraoperative bleeding volume and operation time in the infected group were higher than those in the non-infected group, and the difference was statistically significant (P<0.05). It is suggested that the above factors were the single risk factors for postoperative incision infection. The logistic regression equation was established with the postoperative incision infection as dependent variable and the indicators with statistical significance between groups as independent variable. Multivariate regression analysis confirmed that the above indicators were independent risk factors for the incision infection of elderly parturients after cesarean section (P<0.05).Conclusion There are many risk factors for incision infection after cesarean section for elderly parturients. We should pay special attention to those parturients with hypertension and diabetes, cesarean section in summer, premature rupture of membranes, high BMI, long time from skin preparation to operation, more times of vaginal examination, more bleeding during operation and long operation time. We should take preventive measures actively to prevent the occurrence of postoperative incision infection.
百度学术
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