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目的了解子宫切除术后手术部位感染(SSI)发生率及危险因素。方法收集2012—2016年临安市人民医院行子宫切除术患者的病历资料,对手术部位感染的发生情况作回顾性分析,采用多因素Logistic回归模型分析手术部位感染发生的危险因素。结果共纳入患者1 346例,发生SSI 47例,发生率为3.49%。多因素Logistic回归分析显示,BMI≥28 kg/m2(OR=2.10,95%CI:1.11~3.97)、糖尿病(OR=1.81,95%CI:1.01~3.85)、恶性肿瘤(OR=5.11,95%CI:2.09~12.49)、ASA评分≥3分(OR=1.90,95%CI:1.08~3.35)、手术时间>95 min(OR=4.22,95%CI:1.49~11.90)、术中出血多而输血(OR=2.74,95%CI:1.49~5.03)、手术方式是经腹子宫切除术(OR=1.87,95%CI:1.20~2.90)、预防用药选择头孢呋辛+甲硝唑(OR=1.92,95%CI:1.23~3.00)与子宫切除术后发生SSI存在统计关联。结论经阴道子宫切除术SSI发生率较低,患者BMI≥28 kg/m2,手术时间>95min等是SSI发生的危险因素。
Objective To investigate the incidence and risk factors of surgical site infection (SSI) after hysterectomy. Methods The clinical data of hysterectomy patients in Lin’an People’s Hospital from 2012 to 2016 were collected. The incidence of surgical site infection was retrospectively analyzed. Multivariate Logistic regression model was used to analyze the risk factors of surgical site infection. Results A total of 1 346 patients were enrolled in this study. 47 patients developed SSI, the incidence was 3.49%. Multivariate Logistic regression analysis showed that BMI≥28 kg / m2 (OR = 2.10, 95% CI: 1.11-3.97), diabetes mellitus (OR = 1.81,95% CI: 1.01-3.85) (OR = 4.22, 95% CI: 1.49 to 11.90), the number of bleeding in the operation was higher than that in the control group (% CI: 2.09-12.49) (OR = 1.87, 95% CI: 1.20-2.90). The preventive treatment was cefuroxime + metronidazole (OR = 1.87, 95% CI: 1.20-2.90) = 1.92, 95% CI: 1.23-3.00) was associated with SSI after hysterectomy. Conclusions Transvaginal hysterectomy has a low incidence of SSI. Patients with BMI≥28 kg / m2 and operation time> 95 minutes are the risk factors of SSI.