Göksever Çelik Hale, Çelik Engin, Turan Gökçe, Seçkin Kerem Doğa, Gedikbaşı Ali
Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
J Infect Dev Ctries. 2017 Apr 30;11(4):355-360. doi: 10.3855/jidc.9053.
The aim of the study was to define the clinical and laboratory characteristics of patients who had surgical site infection (SSI) after hysterectomy.
This study was a retrospective cohort study. The patient data of 840 subjects who had undergone any type of hysterectomy and reported SSI after surgery were obtained from the archives of a tertiary referral center. The different types of hysterectomy procedures performed on these patients included total abdominal hysterectomy (TAH), laparoscopic hysterectomy (LH), and vaginal hysterectomy (VH). In addition, age, body mass index (BMI), preoperative and postoperative blood parameters, gravidity, and parity were also documented.
TAH, LH, and VH were performed on 63.2% (n = 531), 21.6% (n = 181), and 15.2% (n = 128) of patients, respectively. Overall, SSIs were observed in 3.7% (n = 31) of all hysterectomy patients. Among them, 4.5% of TAH patients, 1.7% of LH patients, and 3.1% of VH patients had SSIs after the hysterectomy operation. Analysis of the data revealed that the patients with SSIs had significantly higher BMIs, lower preoperative hemoglobin, lower postoperative hemoglobin and hematocrit, and higher postoperative platelet counts compared to patients who did not have any SSIs.
High BMI, blood loss during surgery, low hematocrit levels, and resulting anemia increased the incidence of SSI after hysterectomy. Among the different types of hysterectomy, LH was found to be relatively better than TAH and VH in preventing the occurrence of SSI.
本研究的目的是确定子宫切除术后发生手术部位感染(SSI)患者的临床和实验室特征。
本研究为回顾性队列研究。从一家三级转诊中心的档案中获取了840例行任何类型子宫切除术并报告术后发生SSI的受试者的患者数据。这些患者接受的不同类型子宫切除手术包括全腹子宫切除术(TAH)、腹腔镜子宫切除术(LH)和阴道子宫切除术(VH)。此外,还记录了年龄、体重指数(BMI)、术前和术后血液参数、孕次和产次。
分别有63.2%(n = 531)、21.6%(n = 181)和15.2%(n = 128)的患者接受了TAH、LH和VH手术。总体而言,在所有子宫切除患者中,3.7%(n = 31)发生了SSI。其中,TAH患者中有4.5%、LH患者中有1.7%、VH患者中有3.1%在子宫切除术后发生了SSI。数据分析显示,与未发生任何SSI的患者相比,发生SSI的患者BMI显著更高,术前血红蛋白更低,术后血红蛋白和血细胞比容更低,术后血小板计数更高。
高BMI、手术期间失血、低血细胞比容水平以及由此导致的贫血增加了子宫切除术后SSI的发生率。在不同类型的子宫切除术中,发现LH在预防SSI发生方面相对优于TAH和VH。