13 236例心脏直视手术术后医院感染调查及危险因素
作者:
作者单位:

作者简介:

杜永全

通讯作者:

中图分类号:

R181.3+2;R654.2

基金项目:


Investigation and risk factors of healthcare-associated infection after 13 236 open heart surgery
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 文章评论
    摘要:

    目的 探讨心脏直视手术术后医院感染特点及其危险因素,为制定干预措施提供理论依据。方法 采用回顾性方法调查2016年1月1日-2019年6月30日某三甲心脏专科医院心脏直视手术后患者医院感染情况,并进行危险因素分析。结果 共调查13 236例患者,其中术后发生医院感染923例,医院感染发病率6.97%。不同术式术后医院感染发病率不同,由高到低依次为复杂先心类手术(13.32%)、大血管类手术(11.60%)、冠脉移植类手术(8.23%)、瓣膜类手术(5.49%)、简单先心类手术(5.45%)。感染类型以下呼吸道感染为主(778例,其中呼吸机相关肺炎154例),其次为上呼吸道感染(42例)、血流感染(34例)、手术部位感染(27例)、泌尿道感染(26例)。多因素logistic回归分析显示,二次手术、异体输血、手术时间>265 min,以及复杂先心类手术是心脏直视手术术后医院感染的独立危险因素。结论 尽量缩短手术时间,减少异体输血,避免二次手术,有利于预防心脏直视手术术后医院感染的发生。

    Abstract:

    Objective To investigate the characteristics and risk factors of healthcare-associated infection(HAI) after open heart surgery, so as to provide theoretical basis for formulating intervention measures. Methods HAI in patients after open heart surgery in a tertiary heart hospital from January 1, 2016 to June 30, 2019 was investigated retrospectively, risk factors were analyzed. Results A total of 13 236 patients were investigated, 923 had post-opera-tive HAI, HAI rate was 6.97%. HAI rate varied with different surgical procedures, from high to low were complex cardiac surgery (13.32%), macrovascular surgery (11.60%), coronary artery transplantation (8.23%), valve surgery (5.49%), and simple cardiac surgery (5.45%). The main infection was lower respiratory tract infection (n=778, including 154 cases of ventilator-associated pneumonia), followed by upper respiratory tract infection (n=42), bloodstream infection (n=34), surgical site infection (n=27) and urinary tract infection (n=26). Multivariate logistic regression analysis showed that secondary surgery, allogeneic blood transfusion, duration of operation>265 minutes, and complex cardiac surgery were independent risk factors for HAI after open heart surgery. Conclusion Shortening operation time, reducing allogeneic blood transfusion and avoiding secondary surgery are beneficial to the prevention of HAI after open heart surgery.

    参考文献
    相似文献
引用本文

肖德才, 杜永全.13 236例心脏直视手术术后医院感染调查及危险因素[J]. 中国感染控制杂志,2020,19(9):843-847. DOI:10.12138/j. issn.1671-9638.20206040.
XIAO De-cai, DU Yong-quan. Investigation and risk factors of healthcare-associated infection after 13 236 open heart surgery[J]. Chin J Infect Control, 2020,19(9):843-847. DOI:10.12138/j. issn.1671-9638.20206040.

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2019-12-04
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2020-09-28
  • 出版日期: