4.5 Article

The risk factors and nursing countermeasures of sepsis after cesarean section: a retrospective analysis

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BMC PREGNANCY AND CHILDBIRTH
卷 22, 期 1, 页码 -

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BMC
DOI: 10.1186/s12884-022-04982-8

关键词

Sepsis; Cesarean section; Care; Prevention; Management

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This study aimed to analyze the risk factors associated with sepsis in patients undergoing cesarean section. The results showed that age, gestational diabetes, vaginal delivery attempt, premature rupture of membranes, preoperative hemoglobin level, estimated blood loss during surgery, and postoperative urinary tube implacement were identified as risk factors for sepsis in cesarean section patients.
Background: Sepsis is a very serious complication of cesarean section, understanding the influencing factors is important to the prevention and management of sepsis. We aimed to analyze the associated risk factors of sepsis of cesarean section, to provide evidences into the clinical management and nursing care of cesarean section. Methods: Patients who underwent cesarean section surgery from January 1, 2017 to June 30, 2021 in our hospital were included. The characteristics of patients were collected and analyzed. Logistic regression analyses were conducted to analyze the influencing factors of sepsis of cesarean section. Results: A total of 3819 patients undergoing cesarean section were included, the incidence of sepsis in patients undergoing cesarean section was 0.84%. There were significant differences in the age, vaginal delivery attempt, premature rupture of membranes, preoperative hemoglobin, estimated blood loss during surgery and postoperative urinary tube implacement between sepsis and no sepsis patients (all p < 0.05). Logistic regression analyses found that age >= 35y(OR3.22, 95%CI 1.20 similar to 5.15), gestational diabetes(OR2.64, 95%CI 1.91 similar to 4.15), vaginal delivery attempt(OR2.05, 95%CI 1.70 similar to 4.42), premature rupture of membranes(OR2.42, 95%CI 1.02 similar to 4.20), preoperative hemoglobin <= 105 g/L(OR4.39, 95%CI 1.02 similar to 7.88), estimated blood loss during surgery >= 400 ml(OR1.81, 95%CI 1.35 similar to 3.01), postoperative urinary tube implacement(OR2.19, 95%CI 1.27 similar to 2.50) were the risk factors of sepsis in patients undergoing cesarean section(all p < 0.05). Escherichia Coli(46.15%), Enterococcus faecalis(17.95%) and Pseudomonas aeruginosa(12.83%) were the most commonly-seen bacteria in sepsis patients. Conclusion: In clinical practice, medical workers should carry out strict management and early prevention of related risk factors during the perioperative period of pregnant women, to effectively reduce the occurrence of sepsis after cesarean section.

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