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目的探讨普外科糖尿病患者感染的危险因素,并进行预防对策分析。方法共纳入1000例入住某院普外科的患者,男性506例,女性494例,平均年龄(58±8)岁。其中合并糖尿病患者90例,根据其是否发生感染分为两组,详细记录其病史及相关信息,应用多因素回归分析进行多因素分析。结果外科患者感染率为6.7%(67/1000),合并糖尿病的患者感染率为18.9%(17/90),明显高于未合并糖尿病患者的感染率[5.5%(50/910)],两组比较差异有统计学意义(P﹤0.05);进一步分析不同部位感染发生显示,有32例(47.8%)患者为手术切口感染,20例(29.9%)患者为呼吸道感染,15例(22.4%)患者为其他感染,两组患者不同部位比较差异无统计学意义(P﹥0.05)。单因素分析结果表明:年龄≥60岁、糖尿病病程≥5年、空腹血糖、住院时间、长期卧床、抗生素使用时间、侵入性操作与普外科糖尿病患者发生感染存在相关性,两组比较差异有统计学意义(P﹤0.05),而性别、HbA1c与普外科糖尿病患者发生感染关系不明显(P﹥0.05)。进一步行多因素分析结果表明:年龄≥60岁、糖尿病病程≥5年、住院时间延长、长期卧床是普外科糖尿病患者发生感染的独立危险因素(P﹤0.05)。结论年龄≥60岁、糖尿病病程≥5年、住院时间延长、长期卧床是普外科糖尿病患者发生感染的独立危险因素,在临床过程中给予必要的干预具有重要的意义。
Objective To explore the risk factors of general surgery diabetic patients and to analyze the preventive measures. Methods A total of 1000 patients admitted to a hospital general surgery, 506 males and 494 females, mean age (58 ± 8) years. 90 patients with diabetes mellitus were divided into two groups according to whether they were infected or not. The history and related information were recorded in detail. Multivariate regression analysis was used to analyze multivariate analysis. Results The infection rate in surgical patients was 6.7% (67/1000), that in patients with diabetes was 18.9% (17/90), significantly higher than that in non-diabetic patients [5.5% (50/910)], (47.8%) were infected by surgical incision, 20 (29.9%) were respiratory tract infection, 15 (22.4%) were infected by respiratory tract infection, ) Patients with other infections, two groups of patients in different parts of the difference was not statistically significant (P> 0.05). The results of univariate analysis showed that there was a correlation between the incidence of diabetes ≥ 5 years, fasting blood glucose, hospital stay, bed rest, duration of antibiotics and invasive surgery in patients with general surgical diabetes, there were statistically significant differences between the two groups (P <0.05), while the gender, HbA1c and general surgical diabetic patients had no significant relationship (P> 0.05). Further analysis of multivariate analysis showed that: ≥60 years of age, duration of diabetes ≥5 years, prolonged hospital stay, long-term bed rest is an independent risk factor for infection in general surgical diabetic patients (P <0.05). Conclusions Age ≥ 60 years, duration of diabetes ≥ 5 years, prolonged hospital stay, and long-term bed rest are independent risk factors for infection in general surgical diabetic patients. It is of great significance in the clinical course to give the necessary intervention.