| 阮晟鸣,单震丽,周 健,丁 一,张 凌.剖宫产产妇并发医院感染的临床特征及相关影响因素研究[J].,2018,(5):880-883 |
| 剖宫产产妇并发医院感染的临床特征及相关影响因素研究 |
| Clinical Features and Related Influencing Factors of Nosocomial Infection in Cesarean Section |
| 投稿时间：2017-09-01 修订日期：2017-09-23 |
| DOI：10.13241/j.cnki.pmb.2018.05.017 |
| 中文关键词: 剖宫产 医院感染 临床特征 影响因素 防控对策 |
| 英文关键词: Cesarean section Nosocomial infection Clinical features Influence factor Prevention and control measures |
| 基金项目:上海市浦东新区卫生系统重点学科群建设资助（PWZxq2014-02） |
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| 中文摘要: |
| 摘要 目的：探讨剖宫产产妇并发医院感染的临床特征及相关影响因素，并提出相应的防控措施。方法：选取自2014年1月至2016年12月间在我院妇产科进行剖宫产手术的产妇4112例，记录产妇感染发生的情况（感染率、感染部位及病原菌分布），并统计分析产妇的基本情况，包括年龄、体质量指数（BMI）、住院时间、基础疾病等基本情况。结果：进行剖宫产的产妇合并发生医院感染的感染率为4.89%（201/4112）；感染部位主要为手术切口感染、泌尿道感染、生殖道感染、盆腔感染、呼吸道感染及皮肤感染，其中手术切口感染所占比例为45.77%；医院感染病例中共培养出5种病原菌共51株，包括金黄色葡萄球菌、葛兰氏阴性杆菌、副流感嗜血菌、粪肠球菌及耐甲氧西林金黄色葡萄球菌；感染因素中年龄、BMI、住院时间、基础疾病情况、医护人员操作的熟练程度、手术时间、术中出血量、术后尿管留置时间及抗菌药物应用与剖宫产产妇并发医院感染之间具有紧密联系（P<0.05），而首次剖宫产手术与剖宫产产妇并发医院感染之间无联系（P>0.05）。结论：剖宫产产妇并发医院感染的发生率较高，而且多种感染因素影响其发生，因此在临床上应采取相应的防控措施，降低感染率，保证产妇和新生儿的身心健康。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical characteristics and related influencing factors of nosocomial infection in lying-in women undergoing cesarean section, and to put forward the corresponding prevention and control measures. Methods: A total of 4112 ly- ing-in women, who underwent cesarean section in obstetrics and gynecology department of Shanghai First Maternity and Infant Health Hospital from January 2014 to December 2016, were selected. The incidence of maternal infection (infection rate, location of infection and distribution of pathogens) was recorded; and the basic situation of lying-in women, including age, body mass index (BMI), length of hospitalization, basic diseases, and other basic conditions, were statistically analyzed. Results: The incidence rate of nosocomial infection in the lying-in women undergoing cesarean section was 4.89%(201/4112). The main infection sites were surgical incision infection, uri- nary tract infection, genital tract infection, pelvic infection, respiratory tract infections and skin infections, in which, the proportion of sur- gical incision infection was 45.77%. 5 kinds of pathogens(altogether 51 strains) were found in the hospital infection cases, including staphylococcus aureus, gram-negative bacillus, haemophilus influenzae, enterococcus faecalis and methicillin-resistant staphylococcus aureus. There was a close link among age, BMI, length of hospitalization, basic diseases, proficiency in the operation of medical person- nel, operation time, the amount of bleeding during operation, the indwelling time of catheter after operation, and application of antibiotics and lying-in women undergoing cesarean section complicated by hospital infection, while there was no connection between the first ce- sarean section and hospital infection of lying-in women undergoing cesarean section. Conclusion: The incidence rate of lying-in women undergoing cesarean section complicated by hospital infection is higher, which is affected by many infectious factors. The correspond- ing prevention and control measures should be taken in the clinic to reduce the infection rate and to ensure the physical and mental health of the maternal and newborn. |
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