Department of Nursing, Quanzhou First Hospital, No. 248 East Street, Quanzhou City, 362002, Fujian Province, China.
BMC Pregnancy Childbirth. 2022 Sep 9;22(1):696. doi: 10.1186/s12884-022-04982-8.
Sepsis is a very serious complication of cesarean section, understanding the influencing factors is important to the prevention and management of sepsis. We aimed to analyze the associated risk factors of sepsis of cesarean section, to provide evidences into the clinical management and nursing care of cesarean section.
Patients who underwent cesarean section surgery from January 1, 2017 to June 30, 2021 in our hospital were included. The characteristics of patients were collected and analyzed. Logistic regression analyses were conducted to analyze the influencing factors of sepsis of cesarean section.
A total of 3819 patients undergoing cesarean section were included, the incidence of sepsis in patients undergoing cesarean section was 0.84%. There were significant differences in the age, vaginal delivery attempt, premature rupture of membranes, preoperative hemoglobin, estimated blood loss during surgery and postoperative urinary tube implacement between sepsis and no sepsis patients (all p < 0.05). Logistic regression analyses found that age ≥ 35y(OR3.22, 95%CI1.20 ~ 5.15), gestational diabetes(OR2.64, 95%CI1.91 ~ 4.15), vaginal delivery attempt(OR2.05, 95%CI1.70 ~ 4.42), premature rupture of membranes(OR2.42, 95%CI1.02 ~ 4.20), preoperative hemoglobin ≤ 105 g/L(OR4.39, 95%CI1.02 ~ 7.88), estimated blood loss during surgery ≥ 400 ml(OR1.81, 95%CI1.35 ~ 3.01), postoperative urinary tube implacement(OR2.19, 95%CI1.27 ~ 2.50) were the risk factors of sepsis in patients undergoing cesarean section(all p < 0.05). Escherichia Coli(46.15%), Enterococcus faecalis(17.95%) and Pseudomonas aeruginosa(12.83%) were the most commonly-seen bacteria in sepsis patients.
In clinical practice, medical workers should carry out strict management and early prevention of related risk factors during the perioperative period of pregnant women, to effectively reduce the occurrence of sepsis after cesarean section.
脓毒症是剖宫产的一种非常严重的并发症，了解其影响因素对于脓毒症的预防和管理非常重要。我们旨在分析剖宫产脓毒症的相关危险因素，为剖宫产的临床管理和护理提供依据。
选取 2017 年 1 月 1 日至 2021 年 6 月 30 日在我院行剖宫产术的患者为研究对象。收集患者的一般资料，采用单因素和多因素 logistic 回归分析剖宫产术后发生脓毒症的影响因素。
共纳入 3819 例行剖宫产术的患者，脓毒症的发生率为 0.84%。脓毒症组与非脓毒症组患者的年龄、阴道试产、胎膜早破、术前血红蛋白、术中估计失血量、术后留置导尿管比较，差异均有统计学意义（均 P<0.05）。logistic 回归分析发现，年龄≥35 岁（OR=3.22，95%CI：1.205.15）、妊娠期糖尿病（OR=2.64，95%CI：1.914.15）、阴道试产（OR=2.05，95%CI：1.704.42）、胎膜早破（OR=2.42，95%CI：1.024.20）、术前血红蛋白≤105 g/L（OR=4.39，95%CI：1.027.88）、术中估计失血量≥400 ml（OR=1.81，95%CI：1.353.01）、术后留置导尿管（OR=2.19，95%CI：1.27~2.50）是剖宫产患者发生脓毒症的危险因素（均 P<0.05）。脓毒症患者最常见的细菌为大肠埃希菌（46.15%）、粪肠球菌（17.95%）和铜绿假单胞菌（12.83%）。
在临床实践中，医务人员应在孕妇围手术期进行严格的管理和早期预防相关危险因素，有效降低剖宫产术后脓毒症的发生。
