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：

胃肠外科; 切口感染; 医院感染; 危险因素; 预防措施

DOI：

10.7507/1002-0179.20130527

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目的　分析胃肠外科手术切口感染的影响因素，为医院感染的防治提供理论依据。方法　回顾性分析2010年12月－2012年12月764例行胃肠外科手术患者的临床资料，并用单因素χ2检验统计分析患者医院感染的危险因素。结果　共有65例患者发生手术切口感染，其感染率为8.5%，且分离培养出合格菌株48株，阳性率73.8%，其中G−菌32株，占66.7%，G+菌16株，占33.3%。G−菌主要以大肠杆菌、变形杆菌、克雷伯杆菌和肠杆菌为主，分别占29.2%、18.8%、12.5%和6.2%；G+菌以肠球菌和表皮葡萄球菌为主，分别占22.9%和10.4%。单因素χ2检验显示年龄＞60岁、手术时间＞120 min、术中有输血、且有肿瘤病变的患者具有较高的切口感染发生率（P＜0.05）。结论　胃肠外科手术切口感染的主要致病菌是G−杆菌，患者的年龄、手术时间、术中输血情况和疾病良恶性质是术后切口感染的高危因素，积极采取相应的预防措施有望减低其感染的发生率。

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. 胃肠外科手术高风险患者危险因素干预与预防[J]. 现代预防医学, 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.	雷泽华, 张道宝, 俞慎林. 外科手术切口感染的危险因素分析及其预防[J]. 现代预防医学, 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.	马红丽. 腹部外科手术切口感染的危险因素及对策[J]. 中华医院感染学杂志, 2011, 2l(7): 1310-1312.
6.	杨锡瑶, 惠锦林, 李丹, 等. 普外科手术患者切口感染相关因素分析[J]. 安徽医药, 2011, 15(12): 1560-1562.
7.	楼晓莉. 普外科切口感染相关因素的研究及预防对策[J]. 中华医院感染学杂志, 2011, 21(21): 4472-4473.
8.	戴江峰, 林智宏, 胡月明. 普外科切口感染影响因素及病原学分析[J]. 中华医院感染学杂志, 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, 罗定存, 卢仙球. 胃大部切除术后感染的危险因素调查[J]. 中华医院感染学杂志, 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.	张才华, 李宁, 王新颖, 等. Lipoplus脂肪乳对胃肠恶性肿瘤患者术后营养状况和早期炎性反应的影响[J]. 中华胃肠外科杂志, 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. 胃肠外科手术高风险患者危险因素干预与预防[J]. 现代预防医学, 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. 　雷泽华, 张道宝, 俞慎林. 外科手术切口感染的危险因素分析及其预防[J]. 现代预防医学, 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. 　马红丽. 腹部外科手术切口感染的危险因素及对策[J]. 中华医院感染学杂志, 2011, 2l(7): 1310-1312.
6. 　杨锡瑶, 惠锦林, 李丹, 等. 普外科手术患者切口感染相关因素分析[J]. 安徽医药, 2011, 15(12): 1560-1562.
7. 　楼晓莉. 普外科切口感染相关因素的研究及预防对策[J]. 中华医院感染学杂志, 2011, 21(21): 4472-4473.
8. 　戴江峰, 林智宏, 胡月明. 普外科切口感染影响因素及病原学分析[J]. 中华医院感染学杂志, 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, 罗定存, 卢仙球. 胃大部切除术后感染的危险因素调查[J]. 中华医院感染学杂志, 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. 　张才华, 李宁, 王新颖, 等. Lipoplus脂肪乳对胃肠恶性肿瘤患者术后营养状况和早期炎性反应的影响[J]. 中华胃肠外科杂志, 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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