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在埃塞俄比亚西部 Nekemte 镇公立医院行剖宫产术的产妇中,手术部位感染的严重程度及其相关因素。

Magnitude and factors associated with surgical site infection among mothers underwent cesarean delivery in Nekemte town public hospitals, western Ethiopia.

机构信息

Department of Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia.

Department of Public Health, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia.

出版信息

PLoS One. 2021 Apr 27;16(4):e0250736. doi: 10.1371/journal.pone.0250736. eCollection 2021.

Abstract

BACKGROUND

Surgical site infection (SSI) is a serious public health problem due to its impacts on maternal morbidity and mortality and it can have a significant effect on quality of life for the patient. However, little has been studied regarding the magnitude and factors associated with SSI among women underwent cesarean delivery (CD) in study area. Therefore, the aim of this study was to assess the magnitude and factors associated with SSI among women underwent cesarean delivery in Nekemte Town Public Hospitals 2020.

METHODS

An institution based cross-sectional study was conducted from January 1/2018 to January 1/2020. A simple random sampling technique was employed to select 401 patient cards from all records women underwent CD from January 1/2018 to January 1/2020. Epidata version 3.2 was used for data entry, and STATA version 14 was used for analysis. A logistic regression model was used to determine the association of independent variables with the outcome variable and adjusted odds ratios (AOR) with 95% confidence interval was used to estimate the strength of the association.

RESULTS

Three hundred eight two (382) cards of women were selected for analysis making a response rate of 95.2%. The mean (±SD) age of the mothers was 25.9 (±4.8) years. The prevalence of SSIs was 8.9% (95% CI: 6.03, 11.76). Age > 35 years (AOR = 5.03, 95% CI:1.69, 14.95), pregnancy-induced hypertension (AOR = 5.63, 95%CI:1.88, 16.79), prolonged labor (AOR = 4.12, 95% CI:1.01, 32.19), receiving general anesthesia (AOR = 3.96 95% CI:1.02, 15.29), and post-operative hemoglobin less than 11 g/dl (AOR = 4.51 95% CI:1.84, 11.07) were significantly associated with the occurrence of SSI after cesarean delivery.

CONCLUSIONS AND RECOMMENDATIONS

The magnitude of post CD SSI in this study was comparable with the sphere standards of CDC guidelines for SSI after CD. Concerned bodies should give due attention the proper utilization of partograph to prevent prolonged labor, and provision of iron folate to increase the hemoglobin level of pregnant mothers in all health institution. In addition, we would recommend the use of spinal anesthesia over general anesthesia.

摘要

背景

手术部位感染(SSI)是一个严重的公共卫生问题,因为它会影响产妇的发病率和死亡率,并会对患者的生活质量产生重大影响。然而,对于在研究地区接受剖宫产的妇女,SSI 的严重程度和相关因素研究甚少。因此,本研究旨在评估 2020 年在 Nekemte 镇公立医院接受剖宫产的妇女中 SSI 的严重程度和相关因素。

方法

本研究为 2018 年 1 月 1 日至 2020 年 1 月 1 日进行的基于机构的横断面研究。采用简单随机抽样技术,从 2018 年 1 月 1 日至 2020 年 1 月 1 日期间所有接受剖宫产的妇女的所有记录中抽取 401 名患者病历。使用 Epidata 版本 3.2 进行数据录入,使用 STATA 版本 14 进行分析。使用逻辑回归模型确定自变量与因变量的关联,并使用调整后的优势比(AOR)和 95%置信区间来估计关联的强度。

结果

共抽取了 382 名妇女的病历进行分析,应答率为 95.2%。母亲的平均(±SD)年龄为 25.9(±4.8)岁。SSI 的患病率为 8.9%(95%CI:6.03,11.76)。年龄>35 岁(AOR=5.03,95%CI:1.69,14.95)、妊娠高血压(AOR=5.63,95%CI:1.88,16.79)、产程延长(AOR=4.12,95%CI:1.01,32.19)、全身麻醉(AOR=3.96,95%CI:1.02,15.29)和术后血红蛋白<11g/dl(AOR=4.51,95%CI:1.84,11.07)与剖宫产术后 SSI 的发生显著相关。

结论和建议

本研究中剖宫产术后 SSI 的严重程度与 CDC 指南关于剖宫产术后 SSI 的标准相当。有关机构应高度重视产程图的正确使用,以防止产程延长,并在所有医疗机构提供铁叶酸以提高孕妇的血红蛋白水平。此外,我们建议使用脊髓麻醉代替全身麻醉。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77c9/8079023/09cd193c6df3/pone.0250736.g001.jpg

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