马丽梅, 毕振旺, 齐加新, 刘伟伟, 滕艾颖, 侯志强, 徐华, 徐恩秀, 肖伟. 2021-2022年某三甲综合医院1005例患者结直肠术后手术部位感染监测分析[J]. 凯发娱乐加盟代理. DOI: 10.3784/jbjc.202307070327
引用本文: 马丽梅, 毕振旺, 齐加新, 刘伟伟, 滕艾颖, 侯志强, 徐华, 徐恩秀, 肖伟. 2021-2022年某三甲综合医院1005例患者结直肠术后手术部位感染监测分析[J]. 凯发娱乐加盟代理. DOI: 10.3784/jbjc.202307070327
Ma Limei, Bi Zhenwang, Qi Jiaxin, Liu Weiwei, Teng Aiying, Hou Zhiqiang, Xu Hua, Xu Enxiu, Xiao Wei. Monitoring of postoperative surgical site infections in 1005 colorectal surgery patients in a grade (A) hospital[J]. Disease Surveillance. DOI: 10.3784/jbjc.202307070327
Citation: Ma Limei, Bi Zhenwang, Qi Jiaxin, Liu Weiwei, Teng Aiying, Hou Zhiqiang, Xu Hua, Xu Enxiu, Xiao Wei. Monitoring of postoperative surgical site infections in 1005 colorectal surgery patients in a grade (A) hospital[J]. Disease Surveillance. DOI: 10.3784/jbjc.202307070327

2021-2022年某三甲综合医院1005例患者结直肠术后手术部位感染监测分析

Monitoring of postoperative surgical site infections in 1005 colorectal surgery patients in a grade (A) hospital

  • 摘要:
    目的  对某三甲综合医院结直肠手术患者进行目标性监测,了解术后手术部位感染(SSI)的发生情况、可能的危险因素及其对术后住院天数的影响。
    方法 按照《WS/T 312-2009 医院感染监测规范》要求,对2021—2022年胃肠外科收入院的所有结直肠手术患者进行SSI目标性监测和出院后随访,指标包括性别、年龄、手术部位、美国麻醉医师协会评分、手术持续时间评分、切口清洁度、美国医院感染监测(NNIS)评分、术后住院天数等14项。 采用R4.2.2软件进行统计学分析,危险因素分析使用单因素logistic回归和多因素logistic逐步回归,P<0.05有统计学意义。
    结果 共纳入1005例结直肠手术患者,发生SSI 95例,发生率为9.45%[95%置信区间(CI):7.80%~11.42%],包括浅表切口感染47例、深部切口感染10例、器官(或腔隙)感染38例;其中,通过出院后随访发现50例,占全部SSI病例的52.63%。 手术持续时间较长[比值比(OR)=1.95,95%CI:1.25~3.06,P=0.003]和切口清洁度为污染(OR=2.68,95%CI:1.16~6.19,P=0.021)是发生结直肠术后感染的独立危险因素,NNIS危险指数较高(2~3分)的患者更易发生SSI(OR=3.05,95%CI:1.59~5.85)。发生器官(或腔隙)感染的患者的术后住院天数显著高于未发生SSI者(14 d vs. 5 d,P<0.001)。
    结论 开展SSI目标性监测和出院后随访是了解SSI发生情况的必要措施;结直肠手术有较高的SSI风险,缩短手术持续时间、降低手术切口污染程度可以有效降低SSI发生率;发生器官(或腔隙)感染可以显著增加患者的术后住院天数。

     

    Abstract:
    Objective To conduct targeted monitoring of colorectal surgery patients in a grade Ⅲ (A) hospital, understand the incidence of postoperative surgical site infection (SSI) and potential risk factors, and its impact on postoperative hospitalization days.
    Methods According to the requirements of the Standard for Nosocomial Infection Surveillance (WS/T 312-2009), all colorectal surgery patients admitted to the gastrointestinal surgery department of the hospital from 2021 to 2022 were subjected to targeted monitoring of SSI and post discharge follow-up. The analysis used 14 indicators, including gender, age, surgical site, American Society of Anesthesiologists score, surgical duration score, incision cleanliness, National Nosocomial Infections Surveillance (NNIS) score, postoperative hospitalization days and others. R4.2.2 software was used for statistical analysis, and risk factor analysis was conducted using univariate logistic regression and multivariate logistic stepwise regression models.
    Results A total of 1005 colorectal surgery patients were included, in whom 95 had SSI (9.45%, 95%CI: 7.80%–11.42%), including 47 superficial incisional infections, 10 deep incisional infections, and 38 organ/space infections; In these cases, and 50 were found through follow-up after discharge, accounting for 52.63%. Long duration of surgery (OR=1.95, 95%CI: 1.25–3.06, P=0.003) and contamination of incision (OR=2.68, 95%CI: 1.16–6.19, P=0.021) were the independent risk factors of postoperative colorectal infections. Patients with a higher NNIS risk index (2–3) were more likely to develop SSI (OR=3.05, 95%CI: 1.59–5.85). The postoperative hospitalization days were significantly longer in patients with organ/space infections than in those without SSI (14 days vs. 5 days, P<0.001).
    Conclusion Targeted monitoring of SSI and follow-up after discharge are necessary to understand the incidence of SSI, and colorectal surgery has a higher risk for SSI. Shortening the duration of surgery and reducing the contamination of surgical incision can effectively reduce the incidence of SSI, and the incidence of organ/space infection can significantly increase the postoperative hospitalization days.

     

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