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目的:通过对儿童外科手术患者手术部位感染的目标性监测,探讨影响儿童外科手术部位感染因素,探讨现行手术前后护理措施的有效性,以及对现行护理措施进行改进。方法:采用回顾性目标研究的方法,对儿童外科手术医生及护理人员进行术前、术中、术后的相关培训和监控,中山市黄埔镇人民医院儿童外科3年内所有手术患儿切口情况由医院感染专职人员进行观察,了解手术切口愈合情况及饮食情况,于术后15~30 d进行电话回访。结果:共有2305例住院患者纳入研究,其中65例发生手术部位感染,感染率2.82%,其中表浅切口感染32例、深部切口感染25例、器官腔隙感染8例;另有732例存在感染或潜在感染的危险,与手术部位感染密切相关的因素有手术类型(P=0.000)、切口类型(P=0.000)以及术中出血(P=0.001)等,与手术时间相关性不大(P=0.230)。结论:儿童外科手术部位感染率在现有感染监测体系及护理措施下,已能控制在一个较好的水平,但需对不同的情况下可能发生的感染因素排查,尽量降低感染的发生率。
OBJECTIVE: To explore the influencing factors of surgical site infection in pediatric surgical patients and to explore the effectiveness of the current nursing measures before and after surgery, as well as to improve the current nursing measures. Methods: The methods of retrospective study of the target, the children of surgical surgeons and nurses were preoperative, intraoperative and postoperative related training and monitoring, Zhongshan City, Huangpu Town People’s Hospital of children surgery within 3 years of all surgical incision children from Hospital staff to observe the full-time infection, surgical incision to understand the healing situation and diet, postoperative 15 ~ 30d telephone interview. Results: A total of 2305 hospitalized patients were included in the study, of which 65 cases had surgical site infection, the infection rate was 2.82%, including 32 cases of superficial incision infection, 25 cases of deep incision infection, 8 cases of organ lacunar infection and 732 cases of infection (P = 0.000), type of incision (P = 0.000) and intraoperative bleeding (P = 0.001), which were not related to operative time (P = 0.230). Conclusion: The infection rate of surgical site in children under the current infection monitoring system and nursing measures can be controlled at a good level. However, the infection factors that may occur in different situations should be investigated to minimize the incidence of infection.