Risk Factors for Incision Infection in Gastrointestinal Surgery and Its Preventive Measures_West China Medical Journal

Authors：

HAN Fang , MENG Yuan , GONG Guojie , ZHAO Bing.

Department of General Surgery, Xinjiang Uygur Autonomous Region People’s Hospital, Urumchi, Xinjiang 830054, P. R. China;

Corresponding?author：

Keywords：

胃腸外科; 切口感染; 醫院感染; 危險因素; 預防措施

DOI：

10.7507/1002-0179.20130527

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目的　分析胃腸外科手術切口感染的影響因素，為醫院感染的防治提供理論依據。方法　回顧性分析2010年12月－2012年12月764例行胃腸外科手術患者的臨床資料，并用單因素χ2檢驗統計分析患者醫院感染的危險因素。結果　共有65例患者發生手術切口感染，其感染率為8.5%，且分離培養出合格菌株48株，陽性率73.8%，其中G?菌32株，占66.7%，G+菌16株，占33.3%。G?菌主要以大腸桿菌、變形桿菌、克雷伯桿菌和腸桿菌為主，分別占29.2%、18.8%、12.5%和6.2%；G+菌以腸球菌和表皮葡萄球菌為主，分別占22.9%和10.4%。單因素χ2檢驗顯示年齡＞60歲、手術時間＞120 min、術中有輸血、且有腫瘤病變的患者具有較高的切口感染發生率（P＜0.05）。結論　胃腸外科手術切口感染的主要致病菌是G?桿菌，患者的年齡、手術時間、術中輸血情況和疾病良惡性質是術后切口感染的高危因素，積極采取相應的預防措施有望減低其感染的發生率。

Citation： HAN Fang,MENG Yuan,GONG Guojie,ZHAO Bing.. Risk Factors for Incision Infection in Gastrointestinal Surgery and Its Preventive Measures. West China Medical Journal, 2013, 28(11): 1665-1667. doi: 10.7507/1002-0179.20130527 Copy

1.	[ ２ ]　何春. 胃腸外科手術高風險患者危險因素干預與預防[J]. 現代預防醫學, 2010, 37(23): 4562-4563.
2.	Mu Y, Edwards JR, Horan TC, et al. Improving risk-adjusted measures of surgical site infection for the National Healthcare Safety Network[J]. Infect Control Hosp Epidemiol, 2011, 32(10): 970-986.
3.	雷澤華, 張道寶, 俞慎林. 外科手術切口感染的危險因素分析及其預防[J]. 現代預防醫學, 2010, 37(4): 789-791.
4.	Haley VB, Van Antwerpen C, Tserenpuntsag B, et al. Use of administrative data in efficient auditing of hospital-acquired surgical site infections, New York State 2009-2010[J]. Infect Control Hosp Epidemiol, 2012, 33(6): 565-571.
5.	馬紅麗. 腹部外科手術切口感染的危險因素及對策[J]. 中華醫院感染學雜志, 2011, 2l(7): 1310-1312.
6.	楊錫瑤, 惠錦林, 李丹, 等. 普外科手術患者切口感染相關因素分析[J]. 安徽醫藥, 2011, 15(12): 1560-1562.
7.	樓曉莉. 普外科切口感染相關因素的研究及預防對策[J]. 中華醫院感染學雜志, 2011, 21(21): 4472-4473.
8.	戴江峰, 林智宏, 胡月明. 普外科切口感染影響因素及病原學分析[J]. 中華醫院感染學雜志, 2012, 22(20): 4503-4504, 4527.
9.	Kim ES, Kim HB, Song KH, et al. Prospective nationwide surveillance of surgical site infections after gastric surgery and risk factor analysis in the Korean Nosocomial Infections Surveillance System (KONIS)[J]. Infect Control Hosp Epidemiol, 2012, 33(6): 572-580.
10.	蔡珂, 羅定存, 盧仙球. 胃大部切除術后感染的危險因素調查[J]. 中華醫院感染學雜志, 2012, 22(2): 284-285.
11.	Oh CA, Kim DH, Oh SJ, et al. Nutritional risk index as a predictor of postoperative wound complications after gastrectomy[J]. World J Gastroenterol, 2012, 18(7): 673-678.
12.	Biffi R, Fattori L, Bertani E, et al. Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing Ionic Silver[J]. World J Surg Oncol, 2012, 10(1): 94-103.
13.	張才華, 李寧, 王新穎, 等. Lipoplus脂肪乳對胃腸惡性腫瘤患者術后營養狀況和早期炎性反應的影響[J]. 中華胃腸外科雜志, 2012, 15(5): 448-451.
14.	Mitra B, Cameron PA, Gruen RL. Aggressive fresh frozen plasma (FFP) with massive blood transfusion in the absence of acute traumatic coagulopathy[J]. Injury, 2012, 43(1): 33-37.

1. [ ２ ]　何春. 胃腸外科手術高風險患者危險因素干預與預防[J]. 現代預防醫學, 2010, 37(23): 4562-4563.
2. 　Mu Y, Edwards JR, Horan TC, et al. Improving risk-adjusted measures of surgical site infection for the National Healthcare Safety Network[J]. Infect Control Hosp Epidemiol, 2011, 32(10): 970-986.
3. 　雷澤華, 張道寶, 俞慎林. 外科手術切口感染的危險因素分析及其預防[J]. 現代預防醫學, 2010, 37(4): 789-791.
4. 　Haley VB, Van Antwerpen C, Tserenpuntsag B, et al. Use of administrative data in efficient auditing of hospital-acquired surgical site infections, New York State 2009-2010[J]. Infect Control Hosp Epidemiol, 2012, 33(6): 565-571.
5. 　馬紅麗. 腹部外科手術切口感染的危險因素及對策[J]. 中華醫院感染學雜志, 2011, 2l(7): 1310-1312.
6. 　楊錫瑤, 惠錦林, 李丹, 等. 普外科手術患者切口感染相關因素分析[J]. 安徽醫藥, 2011, 15(12): 1560-1562.
7. 　樓曉莉. 普外科切口感染相關因素的研究及預防對策[J]. 中華醫院感染學雜志, 2011, 21(21): 4472-4473.
8. 　戴江峰, 林智宏, 胡月明. 普外科切口感染影響因素及病原學分析[J]. 中華醫院感染學雜志, 2012, 22(20): 4503-4504, 4527.
9. 　Kim ES, Kim HB, Song KH, et al. Prospective nationwide surveillance of surgical site infections after gastric surgery and risk factor analysis in the Korean Nosocomial Infections Surveillance System (KONIS)[J]. Infect Control Hosp Epidemiol, 2012, 33(6): 572-580.
10. 　蔡珂, 羅定存, 盧仙球. 胃大部切除術后感染的危險因素調查[J]. 中華醫院感染學雜志, 2012, 22(2): 284-285.
11. 　Oh CA, Kim DH, Oh SJ, et al. Nutritional risk index as a predictor of postoperative wound complications after gastrectomy[J]. World J Gastroenterol, 2012, 18(7): 673-678.
12. 　Biffi R, Fattori L, Bertani E, et al. Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing Ionic Silver[J]. World J Surg Oncol, 2012, 10(1): 94-103.
13. 　張才華, 李寧, 王新穎, 等. Lipoplus脂肪乳對胃腸惡性腫瘤患者術后營養狀況和早期炎性反應的影響[J]. 中華胃腸外科雜志, 2012, 15(5): 448-451.
14. 　Mitra B, Cameron PA, Gruen RL. Aggressive fresh frozen plasma (FFP) with massive blood transfusion in the absence of acute traumatic coagulopathy[J]. Injury, 2012, 43(1): 33-37.

West China Medical Journal

Risk Factors for Incision Infection in Gastrointestinal Surgery and Its Preventive Measures

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