Dhaliwal J K, El-Shafei A M, Al-Sharqi M R, Jothy K R, Vijayan U, Qadri A
Department of Obstetrics Obstetrics and Gynecology, Salmaniya Medical Complex, PO Box 12, Bahrain.
Saudi Med J. 2000 Mar;21(3):270-3.
To study the incidence and risk factors for postoperative infection following cesarean sections and major gynecological surgery.
Postoperative infection was documented in the specified registers in all patients following cesarean sections and major gynecological surgery from January 1997 to December 1998. This study was a part of the prospective analysis of hospital-based morbidity and mortality in the Department of Obstetrics and Gynecology.
There were a total of 89 cases of postoperative infections amongst 4,032 patients undergoing major operations giving an overall infection rate of 2.2%. The morbidity due to infections was 3.3% in cesarean sections and 0.9% in major gynecological surgery. Abdominal hysterectomies had a higher infection rate than vaginal surgery. The most common causative organisms isolated were Enterococcus, Staphylococcus and Klebsiella species.
It was found that vaginal flora was a significant source of contamination during surgery, which could be minimised by local sterilisation methods. The high infective morbidity in abdominal hysterectomies needs further analysis of the risk factors. Infection surveillance with a regular review of antibiotic protocols is recommended.
研究剖宫产及妇科大手术后手术部位感染的发生率及危险因素。
记录1997年1月至1998年12月期间所有剖宫产及妇科大手术患者在特定登记册中的术后感染情况。本研究是妇产科基于医院的发病率和死亡率前瞻性分析的一部分。
4032例接受大手术的患者中共有89例术后感染，总体感染率为2.2%。剖宫产术后感染发病率为3.3%，妇科大手术为0.9%。腹部子宫切除术的感染率高于阴道手术。分离出的最常见病原体为肠球菌、葡萄球菌和克雷伯菌属。
发现阴道菌群是手术期间污染的重要来源，可通过局部消毒方法将其降至最低。腹部子宫切除术的高感染发病率需要进一步分析危险因素。建议进行感染监测并定期审查抗生素使用方案。
