摘要
目的探讨产妇产褥期感染的病原学分布及感染的危险因素分析。方法选取2015年6月-2016年10月医院收治的产妇483例作为研究对象,调查产褥期感染的情况,对感染产妇进行分析,收集样本进行病原学检测,运用单因素及多因素logistic线性回归分析方法探讨发生感染的危险因素。结果 483例产妇共发生产褥期感染17例,感染率为3.52%,其中8例发生在会阴切口占47.06%;17例产妇共检出59株病原菌,其中革兰阴性菌24株占40.68%,革兰阳性菌30株占50.85%;单因素分析结果表明:产程(活跃期)延长(>8h)、破膜时间长(>12h)、剖宫产、医源性操作不当、产前产后出血、胎膜早破、合并慢性病、贫血的产妇出现感染的概率明显高于其他产妇,差异有统计学意义(P<0.05),logistic多因素结果显示:产程(活跃期)延长(>8h)、胎膜早破、医源性操作不当、产前产后出血是产妇产褥期感染的独立危险因素。结论产妇产褥期易受到多种病原菌感染,针对产褥期感染的病原菌使用相应的抗菌药物至关重要,但更为重要的是根据产褥期感染的危险因素采取针对性地预防措施,减少产褥期感染的发生率。
OBJECTIVE To explore the distribution of pathogens of puerperal infection in parturient women and to analyze the risk factors of infection.METHODS A total of 483 parturient women who were admitted to the hospital from Jun.2015 to Oct.2016 were investigated for the incidence of puerperal infection.The infected parturient women were analyzed,the samples were collected for etiology detection,and univariate analysis and multivariable logistic regression analysis were used to explore the risk factors of infections.RESULTS There were 17 cases of puerperal infection in 483 cases,and the infection rate was 3.5%,including 8 cases in the perineal incision,accounting for 47.1%.Totally 59 cases of pathogens were detected from 17 cases of puerperal infection,including 24 strains of gram-negative bacteria,accounting for 40.68%,and 30 strains of gram-positive bacteria,accounting for 50.85%.Univariate analysis results showed that the incidence of infection of parturient women with the labor（active）prolonging（〉 8 h）,long rupture time（ 〉12 h）,cesarean section,iatrogenic improper operation,prenatal and postpartum hemorrhage,premature rupture of membranes,with chronic diseases and anemia was significantly higher than that of other women（P〈0.05）.Multivariable logistic regression analysis showed that：the labor（active）prolonging（ 〉8 h）,premature rupture of membranes,iatrogenic improper operation and prenatal and postpartum hemorrhage were independent risk factors for maternal puerperal infection.CONCLUSION Puerperal period is easy to be infected by a variety of pathogenic bacteria,and using the appropriate antimicrobial agents according to the puerperal infection pathogens is important,but more important is to implement targeted prevention measures according to the risk factors of puerperal infection,so as to reduce the incidence of puerperal infection.
作者
黄素静
关红琼
李婷娜
吴海芳
陈丽花
HUANG Su-jing GUAN Hong-qiong LI Ting-na WU Hai-fang CHEN Li-hua(The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第20期4761-4763,4771,共4页
Chinese Journal of Nosocomiology
关键词
产褥期
感染
病原学分析
危险因素
Puerperal period
Infection
Etiology analysis
Risk factors
