上睑退缩患者术后切口感染的危险因素分析及防控

目的探讨上睑退缩患者术后切口感染的危险因素及防控措施。方法选取2009年至2019年我科因各类原因引起的上睑退缩并进行手术治疗的患者606例为研究对象,根据术后是否发生切口感染分为感染组(30例)与非感染组(576例)。分析患者切口感染的发生率与病原菌分布,并利用Logistic回归分析进行危险因素分析。结果共出现30例(4.95%)术后切口感染患者,其中外伤性、Graves眼病与上睑下垂术后源性患者分别为9、12、9例。30例切口感染患者共分离出34株病原菌,其中革兰阳性菌19株(55.88%),革兰阴性菌12株(35.29%),真菌3株(8.82%)。年龄(OR=0.188,P=0.006)、糖尿病(OR=0.234,P=0.005)、BMI(OR=0.151,P=0.001)、住院时间(OR=1.276,P=0.005)与上睑退缩原因(OR=0.177,P=0.006)是术后切口感染的独立危险因素。结论上睑退缩患者术后切口感染病原菌主要为革兰阳性菌。术后切口感染与高龄、合并糖尿病、高BMI指数、住院时间长、外伤性上睑退缩具有显著相关性。

The prevention and risk factors of incision infection in patients with upper eyelid retraction

Objective To discuss the risk factors and prevention and control measures of incision infection in patients with upper eyelid retraction. Methods A total of 606 patients with upper eyelid retraction caused by various reasons who received surgery in our department from 2009 to 2019 were enrolled. According to whether incision infection occurred after surgery, the patients were divided into the infection group(30 cases) or non-infection group(576 cases). The incidence of incision infection and the distribution of pathogenic bacteria were analyzed, and the risk factors were analyzed by using logistic regression. Results There were 30 cases(4.95%) of postoperative incision infection, including 9 cases of trauma, 12 cases of Graves′ ophthalmopathy and 9 cases of ptosis. A total of 34 strains of pathogenic bacteria were isolated from 30 patients with incision infection, including 19 Gram-positive strains(55.88%), 12 Gram-negative strains(35.29%) and 3 fungal strains(8.82%). Age(OR=0.188, P=0.006), diabetes mellitus(OR=0.234, P=0.005), BMI(OR=0.151, P=0.001), length of hospital stay(OR=1.276, P=0.005) and reasons of upper eyelid retraction(OR=0.177, P=0.006) were independent risk factors for postoperative incision infection. Conclusion Gram-positive bacteria were the main pathogenic bacteria of the infection. Postoperative incision infection was significantly correlated with advanced age, diabetes mellitus, high BMI, long hospital stay, and traumatic upper eyelid retraction.