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剖宫产术后手术部位感染及其相关因素:来自埃塞俄比亚一家公立医院的横断面研究

Surgical site infection and its associated factors following cesarean section: a cross sectional study from a public hospital in Ethiopia.

作者信息

Gelaw Kelemu Abebe, Aweke Amlaku Mulat, Astawesegn Feleke Hailemichael, Demissie Birhanu Wondimeneh, Zeleke Liknaw Bewket

机构信息

Department of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.

Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

出版信息

Patient Saf Surg. 2017 Jun 12;11:18. doi: 10.1186/s13037-017-0131-3. eCollection 2017.

Abstract

BACKGROUND

A cesarean section is a surgical procedure in which incisions are made through a woman's abdomen and uterus to deliver her baby. Surgical site infections are a common surgical complication among patients delivered with cesarean section. Further it caused to increase maternal morbidity, stay of hospital and the cost of treatment.

METHODS

Hospital based cross-sectional study was conducted to assess the magnitude of surgical site infection following cesarean Site Infections and its associated factors at Lemlem Karl hospital July 1, 2013 to June 30, 2016. Retrospective card review was done on 384 women who gave birth via cesarean section at Lemlem Karl hospital from July 1, 2013 to June 30, 2016. Systematic sampling technique was used to select patient medical cards. The data were entered by Epi info version 7.2 then analyzed using Statistical Package for Social Sciences windows version 20. Both bivariate and multivariate logistic regression was done to test association between predictors and dependent variables. value of < 0.05 was considered to declare the presence of statistically significantly association.

RESULTS

Among 384 women who performed cesarean section, the magnitude of surgical site infection following cesarean section Infection was 6.8%. The identified independent risk factors for surgical site infections were the duration of labor AOR=3.48; 95%CI (1.25, 9.68), rupture of membrane prior to cesarean section AOR=3.678; 95%CI (1.13, 11.96) and the abdominal midline incision (AOR=5.733; 95%CI (2.05, 16.00).

CONCLUSIONS

The magnitude of surgical site infection following cesarean section is low compare to other previous studies. The independent associated factors for surgical site infection after cesarean section in this study: Membranes rupture prior to cesarean section, duration of labor and sub umbilical abdominal incision. In addition to ensuring sterile environment and aseptic surgeries, use of WHO surgical safety checklist would appear to be a very important intervention to reduce surgical site infections.

摘要

背景

剖宫产是一种通过切开女性腹部和子宫来分娩婴儿的外科手术。手术部位感染是剖宫产产妇常见的手术并发症。此外,它还会导致产妇发病率增加、住院时间延长和治疗费用上升。

方法

于2013年7月1日至2016年6月30日在莱姆勒姆·卡尔医院开展了一项基于医院的横断面研究,以评估剖宫产术后手术部位感染的发生率及其相关因素。对2013年7月1日至2016年6月30日在莱姆勒姆·卡尔医院剖宫产分娩的384名女性进行回顾性病历审查。采用系统抽样技术选取患者病历。数据通过Epi info 7.2版本录入,然后使用社会科学统计软件包Windows版20进行分析。采用双变量和多变量逻辑回归分析来检验预测因素与因变量之间的关联。P值<0.05被认为具有统计学显著关联。

结果

在384例行剖宫产的女性中,剖宫产术后手术部位感染率为6.8%。确定的手术部位感染独立危险因素包括产程时长(比值比[AOR]=3.48;95%置信区间[CI](1.25, 9.68))、剖宫产术前胎膜破裂(AOR=3.678;95%CI(1.13, 11.96))以及腹部中线切口(AOR=5.733;95%CI(2.05, 16.00))。

结论

与以往其他研究相比,剖宫产术后手术部位感染率较低。本研究中剖宫产术后手术部位感染的独立相关因素为:剖宫产术前胎膜破裂、产程时长和脐下腹部切口。除确保无菌环境和进行无菌手术外,使用世界卫生组织手术安全核对表似乎是减少手术部位感染的一项非常重要的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0b3/5469177/f1f998256065/13037_2017_131_Fig1_HTML.jpg

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