Journal of Advanced Biomedical Sciences
مجله علوم زیست پزشکی پیشرفته
J Adv Biomed Sci.
Medical Sciences
http://jabs.fums.ac.ir
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admin
2783-1523
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jalali
1397
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gregorian
2018
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بررسی میزان عفونت بعد از سزارین و عوامل مرتبط با آن در زنان مراجعهکننده به بیمارستان ولیعصر فسا 1394
Evaluation of wound complications after cesarean section and its related factors in women referring to Vali-e-Asr hospital FASA 1394
زنان و زايمان
Gynecology & Obstetrics
پژوهشي
Research
<p dir="RTL"><strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">زمینه</span></span></span></strong> <strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">و</span></span></span></strong> <strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">هدف:</span></span></span></strong> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">آندومتریت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">شایعترین</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">عارضه</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">سزارین</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">است</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">و</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">عوارضی</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">مثل</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">طولانی</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">شدن</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">مدت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">بستری،</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">تحمیل</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">هزینههای</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">اضافی،</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">کاربرد</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">طولانیمدت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">آنتیبیوتیکها، ایجاد</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">چسبندگی</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">و</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">نازایی</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">را</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">به دنبال</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">دارد.</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">فراوانی</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">عفونت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">پس</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">از</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">سزارین</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">3</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">تا 15</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">درصد تخمین</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">زده</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">شده</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">است.</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">میزان</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">بروز</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">عفونت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">به</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">عوامل</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">اجتماعی -</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">اقتصادی</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">بستگی</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">دارد</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">و</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">با</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">کاربرد</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">داروهای</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">ضدمیکروبی</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">در قبل از</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">عمل</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">تغییر</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">چشمگیری</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">کرده</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">است.</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><br>
<strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">مواد و روشها:</span></span></span></strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;"> مطالعه حاضر، مطالعه مقطعی - تحلیلی است.</span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;"> اطلاعات </span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">از ۳۰۰ نفر </span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">که در بیمارستان ولیعصر فسا در سال ۹۴ عمل سزارین شده بودند توسط چکلیست جمعآوری گردید. دادهها</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">با</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">نرمافزار</span></span></span> <span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:8.0pt;">spss </span></span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">و آزمونهای آماری</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">کای</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">اسکویر</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">و</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">تی</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">تست</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">مستقل </span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">و با در نظر گرفتن آلفای 05/0 آنالیز</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">شدند</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">.</span></span></span></span><br>
<strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">نتایج:</span></span></span></strong> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">از</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">بین افراد</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">موردمطالعه</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">۱۵</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">نفر</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">(۵%)</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">عفونت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">پس</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">از</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">زایمان</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">داشتند.</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">بین</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">عفونت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">پس</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">از</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">زایمان</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">و</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">نوع</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">سزارین (انتخابی</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">یا اورژانسی)</span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">، سطح تحصیلات، سن مادر، تعداد بارداری، مراقبتهای پره ناتال، نوع بیهوشی، وزن پایان بارداری، </span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">ارتباط معنیداری مشاهده شد. اما ازنظر میانگین سنی زنان، پارگی کیسه آب، دیابت بارداری، </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:8.0pt;">BMI</span></span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">، دریافت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">آمپول اکسی توسین با</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">عفونت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">پس</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">از</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">سزارین ارتباط</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">معنیداری مشاهده نشد</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">.</span></span></span></span><br>
<strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">نتیجهگیری</span></span></span></strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">: سطح تحصیلات، تعداد بارداری</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">و مراقبتهای پره ناتال</span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">، نوع عمل سزارین و نوع بیهوشی</span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;"> از</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">عوامل</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">خطر</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">عفونت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">بعد</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">از</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">سزارین</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">است</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">امید</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">است</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">با</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">کنترل</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">عوامل</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">قابلپیشگیری</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">میزان</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">بروز</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">این</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">عارضه</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">خطرناک</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">و</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">تبعات بهداشتی</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">آن</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">برای</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">مادر</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">و</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">همچنین</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">نظام</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">سلامت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">کاهش</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">یابد</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">.</span></span></span></span></p>
<p><strong>Background & Objectives: </strong>Endometritis is the most common complication of cesarean section and can cause complications such as prolonged hospitalization, additional costs, establish long-term use of antibiotics, adhesions and infertility. The prevalence of cesarean section infection has been estimated 3 to 15 percent. The incidence of infection depends on socio-economic factors, length of labor, parity, the duration of the rupture of membranes (ROM) or amniorrhexis, and the mode of delivery. The perioperative application of antimicrobial drugs has changed it radically.<br>
<strong>Material & Methods: </strong>This is a cross-sectional study that required information was collected from 300 women who had cesarean in Vali-e-Asr hospital. A questionnaire was filled out at mothers’ bed, in women's ward. Data were analyzed by chi square test through SPSS software. (P<0.05)<span dir="RTL"></span><br>
<strong>Results: </strong>Among the 300 cases, 15 patients (5%) had postpartum infection. There was a significant difference between post section infection and cesarean section (elective or emergency), maternal education level, maternal age and parity, prenatal care, type of anesthesia. There was no significant relationship between infection after cesarean section and average age of the women, PROM, gestational diabetes, BMI.<br>
<strong>Conclusion: </strong>Education level, parity and prenatal care, type of cesarean section, type of anesthesia, are the risk factors of post cesarean infection. We hope to control the incidence of preventable dangerous complications of post section infection and reduce health consequences for the mother as well as the health system.<br>
</p>
بارداری, سزارین, عفونت زخم جراحی
pregnancy, cesarean section, Surgical Wound Infection
701
707
http://jabs.fums.ac.ir/browse.php?a_code=A-10-201-3&slc_lang=fa&sid=1
Zahra
Moradi
زهرا
مرادی
100319475328460017744
100319475328460017744
No
School of Nursing and Midwifery,Fasa University of Medical Sciences, Fasa, Iran
دانشکده پرستاری، دانشگاه علوم پزشکی فسا، فسا، ایران
Parvin
Moradi
پروین
مرادی
100319475328460017745
100319475328460017745
No
Department of Obstetrics and Gynecology; School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
دانشگاه علوم پزشکی فسا، فسا، ایران
Mehdi
Sharafi
مهدی
شرفی
mehdisharafi_2002@yahoo.com
100319475328460017746
100319475328460017746
Yes
Noncommunicable Diseases Research center, University of Medical Sciences, Fasa, Iran
مرکز تحقیقات بیماریهای غیر واگیر، دانشگاه علوم پزشکی فسا، فسا، ایران
Zahra
Akbarzadeh
زهرا
اکبرزاده
100319475328460017747
100319475328460017747
No
Public Health Department, University of Medical Sciences, Fasa, Iran
گروه بهداشت عمومی، دانشگاه علوم پزشکی فسا، فسا، ایران