宫颈癌根治术后医院感染病原菌及影响因素分析
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摘要
目的宫颈癌根治术后医院感染病原菌及影响因素分析,为宫颈癌根治术患者术后医院感染的预防提供依据。方法回顾性分析2008年1月-2016年1月医院行宫颈癌根治术的152例宫颈癌患者临床资料,调查患者术后医院感染率,并采用单因素分析及多因素Logistic回归分析探讨宫颈癌根治术术后医院感染病原菌及影响因素。结果 152例患者术后医院感染31例,感染率为20.39%;感染部位主要以泌尿道感染和手术切口感染为主,分别占32.26%、25.81%,31例医院感染患者,共检出病原菌39株,其中革兰阴性菌25株,占64.10%,革兰阳性菌11株,占28.21%,真菌3株,占7.69%;单因素分析以及多因素Logistic回归分析显示,尿管留置时间、年龄、化疗、住院时间以及糖尿病为影响宫颈癌患者术后医院感染的重要因素。结论宫颈癌根治术患者术后医院感染率较高,医院感染的相关因素较多,应引起临床工作者的重视。
OBJECTIVE To investigate the pathogens causing postoperative nosocomial infections in radical hysterectomy patients and explore the influencing factors so as to provide guidance for prevention of the postoperative nosocomial infections in the radical hysterectomy patients.METHODS The clinical data of 152 cervical cancer patients who underwent the radical hysterectomy in the hospital from Jan 2008 to Jan 2016 were retrospectively analyzed,the incidence of postoperative nosocomial infections was investigated,and univariate analysis and multivariate logistic regression analysis were performed for the pathogens and the influencing factors for the postoperative nosocomial infections in the radical hysterectomy patients.RESULTS Of the 152 patients,31 had postoperative nosocomial infections,with the infections rate 20.39%,32.26% of whom had urinary tract infection,and 25.81%had surgical incision infections.A total of 39 strains of pathogens were isolated from the 31 patients with nosocomial infection,25(64.10%)of which were gram-negative bacteria,11(28.21%)were gram-positive bacteria,and 3(7.69%)were fungi.The univariate analysis and multivariate logistic regression analysis indicated that urinary catheter indwelling time,age,chemotherapy,length of hospital stay and diabetes mellitus were the influencing factors for the postoperative nosocomial infections in the radical hysterectomy patients.CONCLUSIONThe incidence of the postoperative nosocomial infections is high in the radical hysterectomy patients;the nosocomial infection is associated with a variety of factors,which should be attached great importance by clinicians.
OBJECTIVE To investigate the pathogens causing postoperative nosocomial infections in radical hysterectomy patients and explore the influencing factors so as to provide guidance for prevention of the postoperative nosocomial infections in the radical hysterectomy patients.METHODS The clinical data of 152 cervical cancer patients who underwent the radical hysterectomy in the hospital from Jan 2008 to Jan 2016 were retrospectively analyzed,the incidence of postoperative nosocomial infections was investigated,and univariate analysis and multivariate logistic regression analysis were performed for the pathogens and the influencing factors for the postoperative nosocomial infections in the radical hysterectomy patients.RESULTS Of the 152 patients,31 had postoperative nosocomial infections,with the infections rate 20.39%,32.26% of whom had urinary tract infection,and 25.81%had surgical incision infections.A total of 39 strains of pathogens were isolated from the 31 patients with nosocomial infection,25(64.10%)of which were gram-negative bacteria,11(28.21%)were gram-positive bacteria,and 3(7.69%)were fungi.The univariate analysis and multivariate logistic regression analysis indicated that urinary catheter indwelling time,age,chemotherapy,length of hospital stay and diabetes mellitus were the influencing factors for the postoperative nosocomial infections in the radical hysterectomy patients.CONCLUSIONThe incidence of the postoperative nosocomial infections is high in the radical hysterectomy patients;the nosocomial infection is associated with a variety of factors,which should be attached great importance by clinicians.
引文
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[11]张佳宇,宋彬,高硕徽,等.胃癌患者腹腔镜胃癌根治术后感染病原菌分布及危险因素分析[J].中国实验诊断学,2016,20(9):1474-1476.
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[15]连兴刚.HPV E6蛋白与宫颈HPV持续感染及宫颈癌发病的相关性研究[J].中国妇幼保健,2014,29(14):2237-2240.
[16]Jaworski R,Haponiuk I,Irga-Jaworska N,et al.Fungal infections in children in the early postoperative period after cardiac surgery for congenital heart disease:a single-centre experience[J].Interact Cardiovasc Thorac Surg,2016,23(3):431-437.
[17]Nelson RE,Carter J,Anand AG.Hypopharyngeal airway surgery for obstructive sleep apnea:morbidity in the early postoperative period[J].J La State Med Soc,2015,167(1):11-16.
[2]吕伟华,高雅丽,陈明雅,等.人乳头状瘤感染与宫颈癌病变关系研究[J].中华医院感染学杂志,2016,26(9):2117-2119.
[3]Zarpelon CS,Netto MC,Jorge JC,et al.Colchicine to reduce atrial fibrillation in the postoperative period of myocardial revascularization[J].Arq Bras Cardiol,2016,107(1):4-9.
[4]Venturoli S,Costa S,Barbieri D,et al.Time to viral clearance after successful conservative treatment for high-risk HPVinfected high-grade cervical intraepithelial neoplasia and early invasive squamous cervical carcinoma[J].Diagn Microbiol Infect Dis,2016,86(3):270-272.
[5]Royo-Villanova Reparaz M,Andreu Soler E,Sánchez Cámara S,et al.Utility of percutaneous dilatational tracheostomy in the inmediate postoperative period of liver transplant[J].Cir Esp,2015,93(2):91-96.
[6]代俊利,闫雷,李金玲,等.宫颈癌术后盆腔囊肿及并发感染的危险因素[J].中国老年学杂志,2015,8(11):3053-3055.
[7]Kim TW,Kim DH,Oh WS,et al.Analysis of the causes of elevated C-reactive protein level in the early postoperative period after primary total knee arthroplasty[J].J Arthroplasty,2016,31(9):1990-1996.
[8]涂国菊,沈振华,赵苏萍,等.黔南地区苗族和布依族宫颈癌及CIN患者HPV感染与FHIT、RARβ蛋白表达比较研究[J].中国妇幼保健,2015,30(12):1823-1826.
[9]Migita K,Takayama T,Matsumoto S,et al.Impact of bacterial culture positivity of the drainage fluid during the early postoperative period on the development of intra-abdominal abscesses after gastrectomy[J].Surg Today,2014,44(11):2138-2145.
[10]杨丽,何艳,马彩玲,等.人乳头瘤病毒疫苗预防宫颈癌及其相关感染有效性及安全性的Meta分析[J].中国全科医学,2015,10(12):1415-1424.
[11]张佳宇,宋彬,高硕徽,等.胃癌患者腹腔镜胃癌根治术后感染病原菌分布及危险因素分析[J].中国实验诊断学,2016,20(9):1474-1476.
[12]章亚文,蔡芸.宫颈癌患者的病原菌分布分析[J].中国临床药理学杂志,2015,9(11):957-959.
[13]Yi PH,Cross MB,Moric M,et al.The 2013Frank Stinchfield Award:diagnosis of infection in the early postoperative period after total hip arthroplasty[J].Clin Orthop Relat Res,2014,472(2):424-429.
[14]冯黎明,裘正军,袁和祥,等.结直肠癌患者术后感染病原菌分布及影响因素分析[J].中华医院感染学杂志,2014,9(11):2763-2765.
[15]连兴刚.HPV E6蛋白与宫颈HPV持续感染及宫颈癌发病的相关性研究[J].中国妇幼保健,2014,29(14):2237-2240.
[16]Jaworski R,Haponiuk I,Irga-Jaworska N,et al.Fungal infections in children in the early postoperative period after cardiac surgery for congenital heart disease:a single-centre experience[J].Interact Cardiovasc Thorac Surg,2016,23(3):431-437.
[17]Nelson RE,Carter J,Anand AG.Hypopharyngeal airway surgery for obstructive sleep apnea:morbidity in the early postoperative period[J].J La State Med Soc,2015,167(1):11-16.