【摘要】 目的调查分析急诊腹部手术(EAS)后手术部位感染(SSI)的现状,并讨论其发生的风险因素。方法前瞻性收集26家医院2018年5月行EAS的293例成年病人的临床资料,包括基本信息、围手术期数据和感染切口微生物培养结果。主要结局指标为EAS术后SSI发生率,次要结局指标为术后住院时间、ICU入住率、ICU住院时间、术后30 d病死率及治疗费用。结果 293例EAS病人中,22例(7.5%)术后发生SSI。SSI的主要病原菌为大肠埃希菌,培养阳性率为36.4%(8/22)。发生SSI的病人较未发生病人的总住院时间和ICU入住时间显著延长,ICU入住率和治疗费用显著提高。多因素分析显示,男性(P=0.030)和手术时间(P=0.007)是发生SSI的危险因素,腹腔镜手术(P=0.022)是发生SSI的保护因素。结论 EAS后SSI发生率为7.5%,SSI导致病人的医疗负担显著提高;在条件允许的情况下选择腹腔镜手术可减少EAS后SSI的发生,对男性病人EAS后的切口须给予相对更多关注。更多还原

【Abstract】 Objective To understand the current status of surgical site infection(SSI)after emergency abdominal surgery(EAS) in China,and to discuss the risk factors.Methods The study included 293 adult patients who underwent EAS in 26 hospitals in China in May 2018. The basic information, perioperative data, and microbial culture results of infected incisions were collected prospectively. The primary outcome measure was the incidence of surgical site infection within 30 days after surgery. Secondary outcome variables were postoperative hospital stay,ICU occupancy,ICU stay,treatment costs,and postoperative30-day mortality.Results Twenty-two(7.5%) patients developed SSI after surgery.The main pathogen of SSI is Escherichia coli [culture positive rate was 36.4%(8/22)]. Patients with SSI had a significantly longer overall hospital stay and ICUstay,and ICU occupancy and treatment were significantly higher. Multivariate logistic regression analysis showed thatmales(P=0.030) and operative time(P=0.007) were risk factors for SSI. Laparoscopic surgery(P=0.022)was aprotective factor for SSI.Conclusion The incidence of SSI after EAS in China is 7.5%,and SSI leads to a significantincrease in the medical burden of patients. Choosing laparoscopic surgery can reduce the incidence of SSI after EAS.Controlling preoperative blood glucose may have positive significance in preventing SSI after EAS.更多还原