剖宫产术后切口感染的危险因素分析及预防策略研究 |
| 李媛媛 |
| 湖北省襄阳市谷城县人民医院妇产科，湖北襄阳，441700 |
| 摘要：剖宫手术在处理难产、妊娠合并症和并发症、降低母儿死亡率中起到了重要作用，随着围产医学的发展、手术及麻醉技术的改进，剖宫产的安全性也在不断提高，与此同时，剖宫产率也随之升高，剖宫产术后切口感染是常见且严重的并发症，不仅延长产妇住院时间，增加医疗负担，还可能引发切口裂开、子宫内膜炎甚至脓毒血症等严重后果，危及产妇安全，因此，深入分析其危险因素并制定科学预防策略具有重要临床意义。目的 分析剖宫产术后切口感染的危险因素并探讨预防策略。从患者自身因素、手术相关因素、围术期管理三个维度深入分析其危险因素，并基于循证医学证据提出涵盖术前优化、术中管理、术后护理及感染监测的综合预防策略，旨在降低临床剖宫产术后切口感染发生率，改善母婴预后提供参考。方法 回顾性分析2022年1月—2024年6月某基层医院收治的800例剖宫产患者临床资料，根据是否发生切口感染分为感染组（52 例）和非感染组（748 例）。采用单因素分析和多因素Logistic回归筛选危险因素，并提出针对性预防措施。结果 单因素分析显示，年龄≥ 35 岁、BMI ≥ 28 kg/m2、糖尿病、手术时间≥ 90 min、急诊剖宫产、切口类型Ⅲ类、胎膜早破、术中出血量≥ 500 mL、抗生素使用不规范为危险因素（P ＜ 0.05）；多因素分析显示，BMI ≥ 28 kg/m2（OR=3.21，95%CI=1.87~5.53）、糖尿病（OR=2.89，95%CI=1.56~5.34）、手术时间≥ 90 min（OR=2.57，95%CI=1.43~4.61）、切口类型Ⅲ类（OR=3.78，95%CI=2.15~6.64）、抗生素使用不规范（OR=2.36，95%CI=1.29~4.33）为独立危险因素（P＜0.01）。结论 剖宫产切口感染受多因素影响，基层医院可通过优化术前评估、规范术中操作及强化术后管理降低感染风险。 |
| 关健词：剖宫产；切口感染；危险因素；预防策略 |
| |
| Analysis of risk factors and preventive strategies forpost-cesarean section incision infection |
| Yuanyuan Li |
| Obstetrics and Gynecology Department of Gucheng County People’s Hospital, Xiangyang, Hubei 441700, China |
| Abstract：Carean section plays an important role in the treatment of dystocia, pregnancy-related complications, and reducingthe mortality rate of mothers and infants. With the development of peratology, the safety of cesarean section is also constantlyimproving, and at the same time, the cesarean section rate is also increasing. Post-cesan section incision infection is a commonand severe complication, which not only extends the hospitalization time of the puerpera, increases the medical burden, but alsomay serious consequences such as incision dehiscence, endometritis, and even sepsis, endangering the safety of the puerpera.Therefore, it is great clinical significance to deeply analyze its risk factors and formulate scientific preventive strategies. ObjectiveTo analyze the risk factors of post-cesarean section incision infection and explore preventive. The risk factors were analyzed in depth from three dimensions: patients’ own factors, surgery-related factors, and perioperative management. Basedon the evidence of evidence-based, a comprehensive preventive strategy covering preoperative optimization, intraoperativemanagement, postoperative nursing, and infection monitoring was proposed in order to reduce the incidence of post-cesareansectionision infection in the clinic and provide a reference for improving the prognosis of mothers and infants. Methods Aretrospective analysis was conducted on the clinical data of 800esarean section patients admitted to a primary hospital from January2022 to June 2024. According to whether incision infection occurred, the patients were into the infection group (52 cases)and the non-infection group (748 cases). Univariate analysis and multivariate Logistic regression were used to screen risk andpropose targeted preventive measures. Results Univariate analysis showed that age ≥ 35 years, BMI ≥ 28 kg/m2, diabetes,surgery ≥ 90 min, emergency cesarean section, incision type III, premature rupture of membranes, intraoperative blood loss ≥500L, and improper use of antibiotics were risk factors (P < 0.05). Multivariate analysis showed that BMI ≥ 28 kg/m2OR=3.21,95%CI=1.87~5.53), diabetes (OR=2.89, 95%=1.56~5.34), surgery time ≥ 90 min (OR=2.57, 95%CI=1.3~4.61), incision typeIII (OR=3.78, 95%CI=2.15~6.64), and improper use of antibiotics (OR=2.36, 95%CI=1.29~4.33) were independent risk factors(P < .01). Conclusion Cesarean section incision infection is affected by many factors. Primary hospitals can reduce the risk ofinfection by optimizing preoperative assessment,izing intraoperative operations, and strengthening postoperative management. |
| Keywords：Cesarean section; Incision infection; Risk factors; prevention strategy |
| |
|
