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目的:通过对基层医院急诊剖宫产术后切口感染患者的相关临床资料进行分析,旨在了解其术后切口感染发生的危险因素,为针对性干预提供依据。方法:选取在江山市人民医院行急诊剖宫产术后发生切口感染的75例产妇为感染组,按照1∶1的比例随机选取同期住院的行急诊剖宫产术后未发生切口感染的75例产妇为对照组,对影响术后切口感染发生的因素进行分析。结果75例切口感染的患者中,腹壁切口处局部红肿痛、腹壁切口处局部渗出液明显增多以及腹壁切口处化脓的人数分别占到总人数的53.3%、34.7%和6.7%;两组患者在术中出血量、手术时间、腹部脂肪厚度、阴道检查次数、肛门检查次数、BMI、夏季手术、胎膜早破、合并基础疾病以及营养不良等方面有显著差异,且差异有统计学意义(P<0.05);Logistic回归分析表明:手术时间≥2h、肛门/阴道检查≥3次、胎膜早破、BMI≥28Kg/m2、合并基础疾病以及夏季手术是急诊剖宫产患者术后切口感染的危险因素(OR>1,P<0.05)。结论:较长的手术时间、较多的肛门/阴道检查次数、胎膜早破、较为肥胖的产妇、合并基础疾病以及夏季手术是基层医院急诊剖宫产患者术后切口感染的危险因素,应针对性做好预防工作。
OBJECTIVE: To analyze the clinical data of patients with incisional wound infection after emergency cesarean section in primary hospital, so as to understand the risk factors of postoperative wound infection and provide basis for targeted intervention. Methods: Seventy-five pregnant women who had incisional infection after emergency cesarean section in Jiangshan People’s Hospital were selected as infection group. According to the ratio of 1: 1, hospitalized patients undergoing emergency cesarean section were randomly selected. Cases of maternal as a control group, the impact of postoperative wound infection factors were analyzed. Results Among the 75 patients with incisional infection, local swelling and pain in abdominal incision, local exudate in abdominal incision and abscess in abdominal incision accounted for 53.3%, 34.7% and 6.7% of the total, respectively. Two groups The patients had significant differences in the amount of bleeding during operation, the operation time, the thickness of abdominal fat, the number of vaginal exams, the number of anal examinations, BMI, summer surgery, premature rupture of membranes, underlying diseases combined with malnutrition, and the difference was statistically significant (P <0.05). Logistic regression analysis showed that the operative time was more than 2 hours, anal / vaginal examination≥3 times, premature rupture of membranes, BMI≥28Kg / m2, combined with underlying diseases and summer surgery were emergency cesarean section postoperative incision Risk factors for infection (OR> 1, P <0.05). CONCLUSIONS: Longer operative time, more anal / vaginal exams, premature rupture of membranes, more obese mothers, combined underlying disease, and summer surgery are risk factors for incisional wound infection in emergency cesarean section patients in primary hospitals Targeted preventive work.