目的 研究和分析外科Ⅲ类手术切口术后感染的危险因素,达到进一步预防外科Ⅲ类手术切口术后感染的目的。方法 研究对象为我科2014年1月—2016年12月普外科的1 816例Ⅲ类手术切口患者,以术后是否发生切口感染为因变量,以性别、年龄、是否切口贴用医用薄膜、切口是否碘伏冲洗等相关因素为自变量,进行Logistic回归分析,统计分析外科Ⅲ类手术切口术后发生感染的危险因素。结果 1 816例外科Ⅲ类手术切口中,术后发生切口感染有218例,切口感染率为12%。单因素分析显示,8项影响因素与Ⅲ类手术切口术后感染具有相关性(P﹤0.01),对具有统计学意义的8影响因素进行多因素Logistic回归分析,结果显示手术切皮前应用薄膜保护切口、术后切口碘伏冲洗及合理应用抗生素为切口感染保护因素(P﹤0.01),而患者年龄、全麻、急诊手术、输血及住院时间为切口感染独立危险因素(P﹤0.01)。结论 手术皮肤切开前应用医用薄膜、关腹后碘伏冲洗伤口对降低Ⅲ类手术切口术后感染发生率有一定效果,值得临床推广。

Objective: To research and analyze the risk factor which lead to type Ⅲ operation incision infection,and prevent the incision infection.Methods: The clinical data of 1816 typeⅢoperation incision patients from the general surgery department during 2001-2016,With incision infection serving as a dependent variable, gender, age, using medical films, rinsing the incision with iodophor after the abdomen closing and other factors as independent variables, single factor analysis and logistic regression analysis were used to identify risk factor for typeⅢoperation incisions.Results: From 1816 typeⅢoperation incision patients,218 patients suffered from incision infection with a infection rate of 12%,Single factor analysis showed that 8 factors had significant effects on infection of type Ⅲ operation incision(P<0.01). Logistic regression analysis showed that there were 8 related factors out of 9 factors,and age,anesthesia,blood transfusion,the days of hospitalization and emergency surgery were possible independent risk factors of incision infection(P<0.01), and the critical pathway,using medical films,rinsing the incision with iodophor after the abdomen closing,reasonable use of antibiotics were protective factors against incision infection(P<0.01),while age,anesthesia,blood transfusion,the days of hospitalization and emergency surgery were possible independent risk factors of incision infection(P<0.01).Conclusion: Using medical films before the skin incising, rinsing the incision with iodophor after the abdomen closing can reduce the rate of incision infection postoperation, it is worthy of clinical promotion.