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目的分析剖宫产切口感染的高危因素并探讨预防策略。方法选择2014年12月-2016年12月在盛京医院进行剖宫产术的1 520例产妇为研究对象,其中出现切口感染患者为48例,统计产妇可能出现的危险因素,应用Logistic回归分析进行分析。结果染者体质量(BMI)、术前血红蛋白量、手术时间与非感染组相比均有明显差异,表现为BMI、术前血红蛋白量明显低于非感染组(P<0.01),手术时间和术中失血量明显高于非感染组(P<0.05);而两组年龄、孕周和失血量比较,差异无统计学意义(P>0.05)。单因素分析显示,年龄>30岁、合并基础疾病、BMI>25 kg/m~2、术中出血量较高、手术时间>60 min、侵入性操作频繁是导致切口感染的因素。多因素分析显示年龄>30岁、BMI>25 kg/m~2、手术时间>60 min、合并糖尿病、高血压等基础疾病以及侵入性操作过多是导致切口感染的危险因素。结论剖宫产术后发生切口感染与多种因素关系密切,应该从控制体质指数、减少手术时间、控制基础合并症和伴发病、减少侵入性操作入手,降低剖宫产切口感染的发生。
Objective To analyze the risk factors of cesarean incision infection and to explore the preventive strategies. Methods A total of 1 520 maternal women who underwent caesarean section in Shengjing Hospital from December 2014 to December 2016 were enrolled in this study. 48 cases of incision infection were included in this study. The possible risk factors of maternal infection were analyzed by logistic regression analysis Analyze. Results The body mass index (BMI), preoperative hemoglobin and operative time were significantly different from those in non-infected group (BMI). The preoperative hemoglobin level was significantly lower than that in non-infected group (P <0.01) The intraoperative blood loss was significantly higher than non-infected group (P <0.05). There was no significant difference in age, gestational age and blood loss between the two groups (P> 0.05). Univariate analysis showed that the age> 30 years old, with underlying diseases, BMI> 25 kg / m ~ 2, high blood loss, operation time> 60 min, frequent invasive operation is the cause of incision infection. Multivariate analysis showed that age> 30 years old, BMI> 25 kg / m ~ 2, operation time> 60 min, combined with diabetes, hypertension and other underlying diseases and invasive operation is too much risk factors incision infection. Conclusion Incisional infection after cesarean section is closely related to many factors. It should reduce the incidence of cesarean section incision infection by controlling the body mass index, reducing the operation time, controlling the basic comorbidities and complications, reducing the invasive operation.