目的 分析外科手术部位感染率过低的原因，掌握手术部位感染诊断标准，减少医院感染漏报，及时发现医院感染流行趋势，采取控制措施，防止医院感染暴发。 方法 选择开展较多、手术部位一旦发生感染对患者安全威胁性较大的手术：包括胆囊切除或（和）胆管手术，结肠、直肠切除术，阑尾切除术，疝手术，乳房切除术，剖宫产，子宫切除术及附件切除术，全髋关节置换术，食道贲门手术，腰椎间盘摘除术，监测时间为2011年1月1日－6月30日及2012年1月1日－6月30日，共监测1 180例手术，对手术部位感染率进行对比分析。 结果 2011年半年监测手术部位感染率1.99%，调整感染率4.74%；比国内报道低6～9倍；通过分析原因，对医院感染诊断标准再培训、加强病原微生物送检等，2012年半年监测手术部位感染率4.68%，调整感染率32.12%；与2011年比较差异有统计学意义（χ2=141.841，P=0.000）。 结论 手术部位感染率偏低的原因是医生漏报所致；采取整改措施后，提高了手术部位感染的识别能力，减少了漏报，对及时发现医院感染暴发具有重要意义。
ObjectiveTo analyze the relevant factors for surgical site infection. MethodsA total of 677 cases of surgery in one hospital from July 1 to December 31 in 2012 were surveyed (not including implant and cardiac intervention surgeries), which were divided into different groups according to the preoperative incision contamination level, and the postoperative healing of incisions were observed closely. After the patients were discharged, we investigated the situation of incisions by phone or periodic review, and forms were filled in on schedule. ResultsBy follow-up evaluation of the 677 cases, the incisions in 12 cases were infected and the infection rate was 1.77%. Polluted and infected (14.28%, 30.76%) incisions caused more infection than the clean and clean-polluted incisions (0.00%, 0.59%). The patients who stayed in hospital for 4 or more than 4 days before surgeries (infection rate was 4.55%) took more risk of infection than the patients whose preoperative time in hospital were 2-3 days (infection rate was 0.60%) and 1 or shorter than 1 day (0.68%). Perioperative use of antibiotics for longer than 72 hours will increase the risk of incision infection than those within 48 hours (7.69%, 0.00%; P=0.002). ConclusionSurgical site infection is related to the incision type. Shortening the preoperative in-hospital time will reduce the risk of infection. Long time use of antibiotics in perioperative period cannot prevent the postoperative infection effectively, but may increase the risk of infection.