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【摘要】 目的：分析消化道手术患者医院感染因素，为制定医院感染的临床干预措施提供依据。方法：选取2013年9月-2014年4月入住本院并接受消化道手术治疗的患者108例为研究对象，采集研究对象的相关信息，根据患者围手术期是否发生感染分为感染组和非感染组，采用单因素方差分析，筛选可能与消化道手术后医院感染有关的因素，然后对筛选出的可能因素进行校正，校正方法为多元Logisitc回归分析，明确消化道手术后医院感染的独立危险因素；采取前瞻性研究方法，选取2014年5月-2015年5月入住本院并接受消化道手术治疗的患者72例为研究对象，按照随机数字表法分为对照组和观察组；对照组根据手术部位感染预防指南（2014年最新版）进行临床护理，观察组在对照组基础上，根据上述独立危险因素，制定临床干预措施，对比两组患者的医院感染发生率。结果：单因素分析显示：医院感染与消化道手术患者的年龄、基础疾病、GCS评分、手术时间、切口类型、有无术后再次手术、有无气管插管/切开、有无术前使用抗生素及术前营养状态方面差异均有统计学意义（P<0.05）；多元Logisitc回归分析显示：GCS评分<7分、手术时间≥1 h、不合理使用抗生素及术前营养不良作为医院感染的独立危险因素。采取临床干预措施后，观察组患者医院感染率为5.56%，对照组为16.67%，两组比较差异有统计学意义（P<0.05）。结论：消化道手术患者医院感染作为多重因素作用的结果，与医院感染发生密切相关的危险因素有GCS评分<7分、手术时间≥1 h、不合理使用抗生素及术前营养不良，根据上述独立危险因素而制定临床干预措施，可显著降低医院感染的发生率，巩固临床疗效及改善患者的预后。
【关键词】 消化道手术； 医院感染； 危险因素； 临床干预措施
【Abstract】 Objective：To analyze the factors of nosocomial infection in patients undergoing gastrointestinal surgery，and providing the basis for the development of clinical interventions.Method：We collected the relevant information of 108 patients who were underwent gastrointestinal surgery from September 2013 to April 2015 in our hospital.The patients were divided into infected group and non-infected group，according to the occurrence of perioperative infection.ANOVA was applied to select the relevant factors with nosocomial infection after gastrointestinal surgery，and then found out possible factors to correct with the correction method Logistic multivariate regression analysis，in order to clear independent risk factors of nosocomial infection after gastrointestinal surgery.We took prospective study and selected 72 patients who were underwent gastrointestinal surgery from May 2014 to May 2015 in our hospital as research objects.The patients were randomly divided into the control group and the observation group.The control group was accepted clinical care according to the surgical site infection Prevention Guidelines（2014 latest edition），while based on the control group，the observation group was cared with clinical interventions according to the independent risk factors above.The nosocomial infection rates of two groups were compared.Result：ANOVA showed that the nosocomial infection after gastrointestinal surgery had statistically significant differences with patient’s age，underlying disease，GCS score，operation time incision type，with or without postoperative reoperation，with or without and antibiotics，and also in terms of preoperative nutritional status（P<0.05）.Logistic multivariate regression analysis showed that the independent risk factors of nosocomial infection after gastrointestinal surgery were GCS score<7 scores，operative time≥1 h，the irrational use of antibiotics before surgery and malnutrition.After taking clinical intervention，the nosocomial infection rates of the observation group was 5.56%，while the control group was 16.67%，there was statistical significance（P<0.05）.Conclusion：Nosocomial infection in patients undergoing gastrointestinal surgery has correction with multiple factors.Among them，the independent risk factors of nosocomial infection after gastrointestinal surgery were GCS score<7 scores，operative time≥1 h，the irrational use of antibiotics before surgery and malnutrition.Taking clinical interventions according to the independent risk factors can significantly reduce the incidence of nosocomial infections，consolidate clinical efficacy and improve patient outcomes.
【关键词】 消化道手术； 医院感染； 危险因素； 临床干预措施
【Abstract】 Objective：To analyze the factors of nosocomial infection in patients undergoing gastrointestinal surgery，and providing the basis for the development of clinical interventions.Method：We collected the relevant information of 108 patients who were underwent gastrointestinal surgery from September 2013 to April 2015 in our hospital.The patients were divided into infected group and non-infected group，according to the occurrence of perioperative infection.ANOVA was applied to select the relevant factors with nosocomial infection after gastrointestinal surgery，and then found out possible factors to correct with the correction method Logistic multivariate regression analysis，in order to clear independent risk factors of nosocomial infection after gastrointestinal surgery.We took prospective study and selected 72 patients who were underwent gastrointestinal surgery from May 2014 to May 2015 in our hospital as research objects.The patients were randomly divided into the control group and the observation group.The control group was accepted clinical care according to the surgical site infection Prevention Guidelines（2014 latest edition），while based on the control group，the observation group was cared with clinical interventions according to the independent risk factors above.The nosocomial infection rates of two groups were compared.Result：ANOVA showed that the nosocomial infection after gastrointestinal surgery had statistically significant differences with patient’s age，underlying disease，GCS score，operation time incision type，with or without postoperative reoperation，with or without and antibiotics，and also in terms of preoperative nutritional status（P<0.05）.Logistic multivariate regression analysis showed that the independent risk factors of nosocomial infection after gastrointestinal surgery were GCS score<7 scores，operative time≥1 h，the irrational use of antibiotics before surgery and malnutrition.After taking clinical intervention，the nosocomial infection rates of the observation group was 5.56%，while the control group was 16.67%，there was statistical significance（P<0.05）.Conclusion：Nosocomial infection in patients undergoing gastrointestinal surgery has correction with multiple factors.Among them，the independent risk factors of nosocomial infection after gastrointestinal surgery were GCS score<7 scores，operative time≥1 h，the irrational use of antibiotics before surgery and malnutrition.Taking clinical interventions according to the independent risk factors can significantly reduce the incidence of nosocomial infections，consolidate clinical efficacy and improve patient outcomes.