本文選題：會陰切開術(shù) + 助產(chǎn)��； 參考：《中華醫(yī)院感染學(xué)雜志》2017年11期

【摘要】：目的探究會陰切開術(shù)助產(chǎn)分娩切口感染的病原菌特點(diǎn)、危險因素及相關(guān)預(yù)防對策,為臨床醫(yī)師在對產(chǎn)婦切口感染的治療與預(yù)防上提供一定參考依據(jù)。方法選擇2012年3月-2015年12月在醫(yī)院行會陰切開術(shù)的孕婦3 520例,采集切口感染產(chǎn)婦的標(biāo)本進(jìn)行病原學(xué)分布、藥敏試驗(yàn)及感染的相關(guān)危險因素分析。結(jié)果 3 520例會陰切開術(shù)分娩產(chǎn)婦中,100例發(fā)生切口感染,感染率為2.8%,共檢出病原菌109株,其中革蘭陽性菌以金黃色葡萄球菌和鏈球菌屬為主,革蘭陰性菌以大腸埃希菌為主,真菌以白假絲酵母菌和光滑假絲酵母菌為主;藥敏結(jié)果顯示,革蘭陽性菌中鏈球菌對青霉素耐藥率為0,陰道加德納菌對氨芐西林和甲硝唑高度敏感,但金黃色葡萄球菌對頭孢類抗菌藥物敏感性較低,特別是對頭孢曲松和頭孢吡肟的耐藥率高達(dá)71.4%和85.7%;革蘭陰性菌對目前臨床常用抗菌藥物相對敏感,特別是對慶大霉素和萬古霉素高度敏感;多因素logistics分析結(jié)果發(fā)現(xiàn),年齡40歲、體質(zhì)量≥24kg/m~2、合并基礎(chǔ)疾病、陰道檢查次數(shù)≥4次、胎膜早破以及產(chǎn)程≥8h是導(dǎo)致會陰切開術(shù)后切口感染的獨(dú)立危險因素。結(jié)論詳細(xì)了解會陰切開術(shù)助產(chǎn)分娩切口感染的病原菌特點(diǎn)及感染的危險因素,并提出相應(yīng)預(yù)防措施,對降低會陰切開術(shù)后切口感染率及降低病原菌感染和預(yù)防耐藥菌株的產(chǎn)生有重要意義,值得臨床推廣。
[Abstract]:Objective to investigate the pathogenic bacteria characteristics, risk factors and related preventive measures of incision infection in parturient delivery after perineal incision, and to provide some references for clinicians in the treatment and prevention of incision infection in parturient. Methods from March 2012 to December 2015, 3 520 pregnant women undergoing perineal incision were collected for pathogenic distribution, drug sensitivity test and risk factors of infection. Results among 3 520 cases of parturient with vaginal incision, 100 cases of incision infection occurred, the infection rate was 2.8%. 109 strains of pathogenic bacteria were detected. Among them, Staphylococcus aureus and Streptococcus spp were dominant in Gram-positive bacteria, and Escherichia coli was the main type of Gram-negative bacteria. The main fungi were Candida albicans and Candida cerevisiae, and the susceptibility of Streptococcus to penicillin in Gram-positive bacteria was 0, and Gardnebacterium vaginalis was highly sensitive to ampicillin and metronidazole. But Staphylococcus aureus was less sensitive to ceftriaxone and cefepime, especially to ceftriaxone and cefepime. The multivariate logistics analysis showed that the age of 40 years old, the body weight 鈮，

本文編號：1921075