神经外科手术患者医院感染及危险因素分析
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李亚斐

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R181.3+2

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Healthcareassociated infection and risk factors in patients undergoing neurosurgical operation
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    摘要:

    目的探讨神经外科手术患者发生医院感染的情况及相关危险因素,为预防术后感染提供理论依据。方法回顾性调查某院2 496例神经外科手术患者临床资料,进行单因素和多因素logistic回归分析,分析手术患者发生医院感染的可能危险因素。结果2 496例手术患者发生医院感染421例,447例次,医院感染率为16.87%,例次率为17.91%;医院感染的主要部位为手术部位(42.06%,188例),其次是下呼吸道(33.56%,150例)和泌尿道(10.51%,47例)等。单因素分析结果显示,年龄、原发疾病、手术持续时间、气管插管/切开、输血、术后二次手术、术前高血糖7项因素是神经外科手术患者医院感染相关危险因素(均P<0.05);logistic回归分析结果表明,年龄≥60岁(OR 95% CI:1.19~2.06)、手术时间≥3 h(OR 95% CI:1.61~2.87)、气管插管/切开(OR 95% CI:2.90~5.50)、输血(OR 95% CI:1.58~2.63)及术前高血糖(OR 95% CI:1.52~2.79)是神经外科手术患者医院感染的独立危险因素。结论神经外科手术患者医院感染的发生与多种因素有关,应加强医院感染的监测,重视各环节的质量控制。

    Abstract:

    ObjectiveTo evaluate the risk factors of healthcareassociated infection(HAI) in patients undergoing neurosurgical operation, and provide reference for preventing postoperative infection.MethodsClinical data of 2 496 patients undergoing neurosurgical operation were analyzed, univariate analysis and multivariate logistic regression analysis on risk factors for HAI were performed.ResultsOf 2 496 patients, 421 developed 447 episodes of HAI, HAI rate and case rate was 16.87% and 17.91% respectively; the main infection site was surgical site(42.06%,188 cases),followed by lower respiratory tract(33.56%,150 cases) and urinary tract(10.51%,47 cases). Univariate analysis showed that the related risk factors for postoperative infection were age, primary diseases, duration of operation, tracheal intubation/tracheotomy, blood transfusion, a second operation, preoperative hyperglycemia(all P<0.05). Multivariate logistic regression analysis showed that age≥60 years old(OR 95% CI:1.19-2.06),duration of operation ≥3 hours(OR 95% CI:1.61-2.87), tracheal intubation/tracheotomy(OR 95% CI:2.90-5.50), blood transfusion(OR 95% CI:1.58-2.63), and preoperative hyperglycemia(OR 95% CI:1.52-2.79) were independent risk factors for infection in patients undergoing neurosurgical operation.ConclusionThe occurrence of HAI in patients undergoing neurosurgical operation is related to multiple factors, surveillance on HAI should be intensified.

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方旭,李亚斐.神经外科手术患者医院感染及危险因素分析[J]. 中国感染控制杂志,2013,12(6):415-417. DOI:10.3969/j. issn.1671-9638.2013.06.005.
FANG Xu, LI Yafei. Healthcareassociated infection and risk factors in patients undergoing neurosurgical operation[J]. Chin J Infect Control, 2013,12(6):415-417. DOI:10.3969/j. issn.1671-9638.2013.06.005.

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  • 收稿日期:2013-03-18
  • 最后修改日期:2013-07-12
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  • 在线发布日期: 2013-11-30
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