【摘要】：目的分析經口寰樞椎復位內固定(TARP)手術患者醫(yī)院感染的危險因素及其對預后的影響,提出臨床管理對策。方法選取醫(yī)院2013年7月1日-2015年6月30日行TARP手術患者121例,分析術后感染率及感染的相關因素。結果 121例TARP手術患者術后發(fā)生醫(yī)院感染20例,感染率為16.53%,感染22例次,例次感染率為18.18%;感染部位以呼吸系統、泌尿系統和手術部位為主,其中下呼吸道感染9例次,占40.91%,泌尿道感染5例次,占22.73%,手術部位4例次,占18.18%;單因素分析有統計學意義的危險因素包括住院時間、手術時間、術中輸血量、術中輸液量、使用呼吸機、合并基礎疾病、口腔疾病、術后發(fā)熱38℃、多次入住ICU及院內獲得多藥耐藥菌;二分類logistics回歸分析顯示,使用呼吸機、院內獲得多藥耐藥菌、口腔疾病及術中輸液量是TARP手術患者發(fā)生醫(yī)院感染的獨立危險因素。結論 TARP手術患者醫(yī)院感染危險因素較多,應針對各種危險因素積極采取預防控制措施,尤其應注意呼吸機管理、多藥耐藥菌管理、口腔護理及控制術中輸液量,以減少醫(yī)院感染,提高治愈率。
[Abstract]:Objective to analyze the risk factors of hospital infection and its influence on prognosis in patients undergoing oral atlantoaxial reduction and internal fixation with (TARP), and to put forward clinical management countermeasures. Methods from July 1, 2013 to June 30, 2015, 121 patients underwent TARP operation in our hospital. The infection rate and related factors were analyzed. Results there were 20 cases of hospital infection, the infection rate was 16.53%, 22 cases were infected, and the infection rate was 18.18%. Respiratory system, urinary system and surgical site were the main sites of infection, including 9 cases of lower respiratory tract infection (40.91%), 5 cases of urinary tract infection (22.73%) and 4 cases of operation site (18.18%). Univariate analysis showed that statistically significant risk factors included hospitalization time, operation time, intraoperative blood transfusion, intraoperative infusion, use of ventilator, combined with basic diseases, oral diseases, postoperative fever at 38 鈩，

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