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[开颅手术患者手术部位感染的危险因素]

[Risk factors for surgical site infections in patients undergoing craniotomy].

作者信息

Cha Kyeong-Sook, Cho Ok-Hee, Yoo So-Yeon

机构信息

Department of Infection Control, St. Vincent's Hospital, Suwon, Korea.

出版信息

J Korean Acad Nurs. 2010 Apr;40(2):298-305. doi: 10.4040/jkan.2010.40.2.298.

Abstract

PURPOSE

The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative surgical site infections (SSIs) after craniotomy.

METHODS

This study was a retrospective case-control study of 103 patients who had craniotomies between March 2007 and December 2008. A retrospective review of prospectively collected databases of consecutive patients who underwent craniotomy was done. SSIs were defined by using the Centers for Disease Control criteria. Twenty-six cases (infection) and 77 controls (no infection) were matched for age, gender and time of surgery. Descriptive analysis, t-test, X(2)-test and logistic regression analyses were used for data analysis.

RESULTS

The statistical difference between cases and controls was significant for hospital length of stay (>14 days), intensive care unit stay more than 15 days, Glasgrow Coma Scale (GCS) score (< or = 7 days), extra-ventricular drainage and coexistent infection. Risk factors were identified by logistic regression and included hospital length of stay of more than 14 days (odds ratio [OR]=23.39, 95% confidence interval [CI]=2.53-216.11) and GCS score (< or = 7 scores) (OR=4.71, 95% CI=1.64-13.50).

CONCLUSION

The results of this study show that patients are at high risk for infection when they have a low level of consciousness or their length hospital stay is long term. Nurses have to take an active and continuous approach to infection control to help with patients having these risk factors.

摘要

目的

本研究的目的是确定开颅术后手术部位感染(SSIs)的患病率、发病率及危险因素。

方法

本研究是一项对2007年3月至2008年12月期间接受开颅手术的103例患者进行的回顾性病例对照研究。对前瞻性收集的连续开颅患者数据库进行了回顾性分析。SSIs采用疾病控制中心的标准进行定义。26例(感染)和77例对照(未感染)在年龄、性别和手术时间方面进行了匹配。采用描述性分析、t检验、X²检验和逻辑回归分析进行数据分析。

结果

病例组和对照组在住院时间(>14天)、重症监护病房停留时间超过15天、格拉斯哥昏迷量表(GCS)评分(≤7分)、脑室外引流和并存感染方面存在显著统计学差异。通过逻辑回归确定的危险因素包括住院时间超过14天(比值比[OR]=23.39,95%置信区间[CI]=2.53 - 216.11)和GCS评分(≤7分)(OR=4.71,95%CI=1.64 - 13.50)。

结论

本研究结果表明,意识水平低或住院时间长的患者感染风险较高。护士必须采取积极持续的感染控制措施,以帮助有这些危险因素的患者。

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