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中华实验和临床感染病杂志(电子版) ›› 2016, Vol. 10 ›› Issue (02) : 213 -216. doi: 10.3877/cma.j.issn.1674-1358.2016.02.017

临床论著

剖宫产术后感染因素分析及护理对策
顾雯雯1()   
  1. 1. 210006 南京市,南京医科大学附属南京医院(南京市第一医院)产房
  • 收稿日期:2015-04-27 出版日期:2016-04-15
  • 通信作者: 顾雯雯

Infection factors and nursing countermeasures of infection after cesarean section

Wenwen Gu1,()   

  1. 1. Department of Obstetric, Affiliated Hospital of Nanjing Medical University (The First Hospital of Nanjing City), Nanjing 210006, China
  • Received:2015-04-27 Published:2016-04-15
  • Corresponding author: Wenwen Gu
引用本文:

顾雯雯. 剖宫产术后感染因素分析及护理对策[J/OL]. 中华实验和临床感染病杂志(电子版), 2016, 10(02): 213-216.

Wenwen Gu. Infection factors and nursing countermeasures of infection after cesarean section[J/OL]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2016, 10(02): 213-216.

目的

分析剖宫产术后感染原因以实施相应的护理对策,以减少剖宫产感染的发生,为临床护理工作提供依据和工作经验。

方法

回顾性分析本科2012至2014年84例剖宫产感染者的临床资料。

结果

84例感染者中,并发症居前三位的分别为剖宫产手术指征胎儿窘迫(21例,25.00%)、产程异常(18例,21.43%)和头盆不称(6例,19.05%);剖宫产感染部位居前三位的分别为手术切口(33例,39.29%)、生殖系统(18例,21.43%)和泌尿系统(14例,16.67%)。患者的年龄、体质量指数(BMI)、产妇是否合并基础病变等因素与产妇剖宫产感染有关。实验室共检出病原菌56株(66.67%),感染病原菌中位于前三位的分别为金黄色葡萄球菌(12株,21.43%)、铜绿假单胞菌(11株,19.64%)、大肠埃希菌(9株,16.07%)。产妇年龄≥ 30岁、体重指数≥ 25、产程≥ 12 h、手术时间≥ 1 h、术中出血量≥ 500 ml、术后留置导尿时间≥ 12 h是引起产妇发生医院感染的高危因素(P均< 0.05)。

结论

对产妇分娩前的保健积极指导,严格控制剖宫产手术的适应证,产妇分娩期间去除不重要的诊疗操作,分娩前科学合理使用抗菌药物,对病房和手术室的严格消毒无菌管理,对产妇剖宫产手术后有针对性的有效护理,能够有效避免剖宫产术后感染的发生。

Objective

To analyze the implementation of corresponding nursing countermeasures to infection after cesarean section cesarean delivery, and to reduce the occurrence of infection, and provide the basis for clinical nursing.

Methods

A retrospective analysis of the clinical data of 84 cases of cesarean section infection from 2012 to 2014 were analyzed, retrospectively.

Results

In the 84 cases of infected patients, cesarean section indications of fetal distress (21 cases), labor abnormalities (18 cases) and head disproportion (6 cases) were the top three constituent ratio: 25.00%, 21.43%, 19.05%; cesarean incision site of infection (33 cases), reproductive system (18 cases) and urinary (14 cases) were the top three constituent ratio: 39.29%, 21.43% and 16.67%; age, body mass index (BMI), maternal factors such as whether a consolidated basis and maternal disease cesarean infection; laboratory pathogens 56 (66.67%), infection pathogens in the top three were Staphylococcus aureus (12, ≥ 21.43%), Pseudomonas aeruginosa (11, ≥ 19.64%), Escherichia coli (9, ≥ 16.07%). The constituent ratios of the infection cases ≥ 30 years old, BMI ≥ 25, labor course ≥ 12 h, operation duration ≥ 1 hour, intraoperativc bleeding volume ≥ 500 ml, and postoperative catheter indwelling time longer than 12 hours, which were defined as the high risk factors for the nosocomial infections in the women undergoing cesarean section (P all < 0.05).

Conclusions

Knowledge of maternity care before positive guidance, strictly control of surgical indications for cesarean section, remove of unimportant check operation during the maternity clinic, the rational use of antibiotics before delivery, strict aseptic sterilization management on the wards and operating rooms, targeted and effective treatments after cesarean section can effectively prevent infection after cesarean section.

表1 剖宫产手术指征构成比
表2 入组患者感染部位和构成比
表3 剖宫产感染危险因素分析及构成比
表4 病原菌分布和构成比
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