心脏直视术后手术部位感染回顾分析.docVIP

心脏直视术后手术部位感染回顾分析 　　[摘要] 目的 分析心脏直视手术术后手术部位感染的相关风险因素，为临床预防和控制术后手术部位感染提供科学依据。 方法 回顾性分析新乡医学院第一附属医院心血管外科2011年1月～2014年10月进行直视下心脏手术患者1623例，其中术后手术部位感染83例，与同期未发生手术部位感染的患者按1∶2配比法进行相关危险因素分析，涉及的风险因素包括性别、年龄、体重指数、吸烟、糖尿病、手术时间等，数据使用SSPS 22.0软件分析。 结果 全部1623例心脏直视手术后手术部位感染患者83例，感染率为5.11%，其中切口浅表部位、深部及纵隔内感染率分别为80.72%、18.07%及1.2%。多因素条件Logistic回归分析认为，手术时间（2.5 h）、术后ICU时间（2 d）、术后发热（术后3 d，≥38.5℃）是手术部位感染的独立相关因素（P 0.05）。 结论 强化无菌操作、减少手术时间、改进术后患者ICU治疗与护理可减少手术部位感染发生率，患者术后ICU停留时间增加和术后发热可能成为手术部位感染的预测或诊断指标。 　　[关键词] 心脏手术；手术部位感染；危险因素 　　[中图分类号] R181.32 [文献标识码] A [文章编号] 1673-7210（2015）05（b）-0039-05 　　Retrospective analysis of the risk factors of surgical site infection in postoperative patients with open heart surgery 　　DING Xuehua1 FU Qinglin1 SUN Wenchao1 HAN Peili1 ZHANG Jie1 Robert J Cusimano2 　　1.Department of Cardiovascular Surgery， the First Affiliated Hospital of Xinxiang Medical University， Henan Province， Xinxiang 453000， China； 2.Division of Cardiac Surgery， Toronto General Hospital， Toronto M5G 2C4， Canada 　　[Abstract] Objective To analyze the risk factors of surgical site infection （SSI） with open heart surgery and provide some scientific basis for prevention and control of SSI. Methods All 1623 cases of patients underwent open heart surgery in Department of Cardiovascular Surgery， the First Affiliated Hospital of Xinxiang Medical University from January 2011 to October 2014 were retrospectively analyzed， and out of which there were 83 cases with SSI. The other contemporaneous patients without SSI were selected by 1∶2 ratio， then multivariate Logistic regression was used to determine the independent association of patient and surgical covariates with risk of any SSI （gender， age， body mass index， smoking， diabetes and operation time）. Data were analyzed by SPSS 22.0. Results There were 83 patients with SSI among 1623 patients after open heart surgery， and the incidence of SSI was 5.11%， including superficial incision site （80.72%）， deep （18.07%）， within the mediastinum （1.2%） infec