摘要
目的剖宫产腹部切口脂肪液化作为剖宫产术后伤口延迟愈合的关键因素,对产妇术后康复造成极大负面影响。为更好地提高手术室护理安全,减少因手术相关因素导致的剖宫产术后切口脂肪液化,本研究探讨剖宫产腹部切口脂肪液化手术相关危险因素,并分析其处理方法。方法选择2016-02-28-2019-03-31大连市妇幼保健院收治的240例剖宫产产妇,其中发生术后腹部切口脂肪液化患者40例为研究对象,针对手术期间相关因素,如手术时间、术中出血、手术室层流级别、手术类型、巡回护士在位率和是否使用高频电刀等进行单因素与多因素Logistic回归分析,明确手术期间相关因素对剖宫产腹部切口脂肪液化的影响。结果单因素分析结果表明,手术时间(χ2=29.486,P<0.001)、术中出血量(χ~2=31.228,P<0.001)、手术室层流级别(χ2=10.101,P=0.001)、手术类型(χ2=6.498,P=0.011)、巡回护士在位率(χ2=17.054,P<0.001)和是否使用高频电刀(χ~2=18.552,P<0.001)是手术期间影响剖宫产腹部切口脂肪液化的危险因素。多因素Logistic回归分析表明,手术时间>2h(OR=10.39,95%CI为1.21~34.40,P=0.01)、术中出血量>400mL(OR=18.57,95%CI为1.59~19.24,P=0.04)、手术室层流级别(OR=5.53,95%CI为3.10~9.83,P<0.01)、急诊手术(OR=6.24,95%CI为1.03~7.45,P=0.04)、巡回护士在位率<90%(OR=2.44,95%CI为1.38~4.31,P<0.01)和使用高频电刀(OR=3.07,95%CI为1.76~5.34,P<0.01)是手术期间影响剖宫产腹部切口脂肪液化的独立危险因素。结论手术时间>2h、术中出血>400mL、手术室层流级别<106、急诊手术、巡回护士在位率<90%及使用高频电刀的剖宫产者是手术期间影响腹部切口脂肪液化的因素。
OBJECTIVE Liquefaction of abdominal incision fat after cesarean section is a key factor for delayed wound healing after cesarean section,which has a great negative impact on the recovery of postpartum women.In order to improve the safety of operating room nursing and reduce the incision fat liquefaction after cesarean section caused by operation related factors,this study explored the related risk factors during the operation of abdominal incision fat liquefaction after cesarean section,and analyzed the treatment methods.METHODS A total of 240 caesarean section parturients admitted in Dalian Maternal and Child Health Hospital from February 28,2016 to March 31,2019 were selected.Among them,40 cases with postoperative abdominal incision fat liquefaction were selected as the research object.Univariate and Logistic regression analysis were performed on the operating room related factors,such as operation time,intraoperative hemorrhage,laminar flow level in the operating room,operation type,on-site rate of itinerant nurses,and whether highfrequency electric knife was used or not.The influence of the operating room related factors on abdominal incision fat liquefaction of caesarean section was clarified,and corresponding treatment measures were proposed for the clear risk factors.RESULTS Univariate analysis showed that operation time(χ~2=29.486,P<0.001),intraoperative bleeding volume(χ~2=31.228,P<0.001),laminar flow level(χ~2=10.101,P=0.001),type of operation(χ~2=6.498,P=0.011),incumbency rate of itinerant nurses(χ~2=17.054,P<0.001)and whether or not to use high frequency electrotome(χ~2=18.552,P<0.001)were risk factors for fat liquefaction in abdominal incision during cesarean section.Multivariate logistic regression analysis showed that the operation time more than 2 hours(OR=10.39,95%CI:1.21-34.40,P=0.01),intraoperative bleeding was more than 400 ml(OR=18.57,95%CI:1.59-19.24,P=0.04),laminar flow level less than 106(OR=5.53,95%CI:3.10-9.83,P<0.01),emergency operation(OR=6.24,95%CI:1.03-7.45,P=0.04),emergency operation(OR=2.44,95%CI:1.38-4.31,P<0.01)and the use of high frequency electrotome(OR=3.07,95%CI:1.76-5.34,P<0.01)were independent risk factors affecting abdominal incision fat liquefaction during cesarean section.CONCLUSION For caesarean section patients with operation time over 2 hours,intraoperative hemorrhage over 400 ml,laminar flow level under in operating room,emergency operation,presence rate of itinerant nurses less than 90%,and use of high-frequency electric knife,clinical attention should be paid to prevent incision fat liquefaction.
作者
郭芳
吴梅
丁浩
GUO Fang;WU Mei;DING Hao(Department of Operation Room,Dalian Maternal and Child Health Hospital,Dalian116033,P.R.China)
出处
《社区医学杂志》
2019年第20期1288-1291,共4页
Journal Of Community Medicine
关键词
剖宫产
腹部切口
脂肪液化
手术室相关
危险因素
cesarean section
abdominal incision
liquefaction of fat
operating room related
risk factors
