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目的:探讨剖宫产手术切口感染的危险因素和病原菌。方法:采用目标性监测的方法,收集剖宫产手术切口感染危险因素和病原学资料,并对资料进行单因素分析与Binary Logistic回归分析。结果:2510例剖宫产中有53例发生切口感染,感染率为2.11%。对资料进行单因素分析发现NNIS、皮下组织最大厚度、术中出血量、低蛋白血症、中/重度贫血、糖尿病、妊娠高血压、阴检次数、宫口开大程度、胎膜早破、羊膜腔感染等因素可能与剖宫产切口感染有关。对资料进行Logistic回归确定NNIS(OR=1.672)、羊膜腔感染(OR=2.141)、术中出血量(OR=1.721)、糖尿病(OR=2.515)、皮下组织最大厚度(OR=1.305)、宫口开大程度(OR=1.158)等因素为剖宫产手术切口感染的独立危险因素。在切口感染的病原菌中,G-杆菌占51.85%(14/27),G+球菌占25.93%(7/27),真菌和厌氧菌各占11.11%(3/27)。结论:对高危人群应采取更严格的预防控制措施以降低剖宫产手术切口感染率。
Objective: To investigate the risk factors and pathogens of cesarean section incision infection. Methods: By means of targeted monitoring, the risk factors and etiological data of incisional wound infection after cesarean section were collected. Univariate analysis and Binary Logistic regression analysis were used to analyze the data. Results: In 2510 cases of cesarean section in 53 cases of incision infection, the infection rate was 2.11%. Univariate analysis of the data found NNIS, the maximum thickness of subcutaneous tissue, intraoperative blood loss, hypoproteinemia, moderate / severe anemia, diabetes, pregnancy-induced hypertension, the number of negative tests, cervix open degree, premature rupture of membranes, Amniotic cavity infection and other factors may be related to incision infection. Logistic regression analysis was used to determine the correlation between NNIS (OR = 1.672), amniotic cavity infection (OR = 2.141), intraoperative blood loss (OR = 1.721), diabetes mellitus (OR = 2.515), subcutaneous tissue thickness (OR = 1.305) Mouth open degree (OR = 1.158) and other factors for cesarean section incision infection independent risk factors. Among the pathogenic bacteria infected by incision, 51.85% (14/27) of G-bacteria, 25.93% (7/27) of G + bacteria and 11.11% (3/27) of fungi and anaerobe respectively. Conclusion: Stringent prevention and control measures should be taken in high-risk groups to reduce the incision infection rate in cesarean section.