目的 探讨妇科恶性肿瘤围术期手术部位感染（surgical site infection，SSI）的危险因素，为临床预防感染、优化患者管理提供依据。方法 回顾性收集2016年6月1日至2024年5月31日在苏州大学附属第一医院行全子宫切除术并确诊为妇科恶性肿瘤的531例患者的临床资料，依据其是否发生SSI分为感染组和非感染组，收集患者的年龄、体重指数、美国麻醉医师协会（ASA）评分、基础病史、血液检查指标、原发疾病、手术情况等变量，采用单因素分析及logistic多因素回归分析。结果 531例患者中，发生SSI的患者有46例，发生率为8.66%。单因素分析显示，年龄、糖尿病史、贫血、ASA评分、手术方式、术中出血量和围术期预防性抗生素的应用方面与SSI的发生相关（P<0.05）。多因素分析进一步证实年龄≥60岁、糖尿病、贫血、ASA评分≥3分、开腹手术及术中出血量≥500mL为SSI的独立危险因素（P<0.05）。结论 高龄、糖尿病、贫血、高ASA评分、开腹手术及术中大量出血是妇科恶性肿瘤患者SSI的主要危险因素。临床应针对性优化围术期管理，如控制血糖、纠正贫血、优化手术方案及减少出血，以降低感染风险，改善患者预后。

Objective To investigate the risk factors for surgical site infection （SSI） during the perioperative period in patients with gynecological malignancies，providing evidence for preventing clinical infection and optimizing patient management. Methods Clinical data of 531 patients who underwent total hysterectomy with a confirmed diagnosis of gynecological malignancies at the First Affiliated Hospital of Soochow University from June 1，2016 to May 31，2024 were retrospectively collected. Patients were divided into an SSI group and a non-SSI group based on infection occurrence. Variables were collected and analyzed using univariate and multivariate logistic regression analyses，including age，body mass index，ASA score，medical history，laboratory blood test results，primary diseases and surgical details. Results Among 531 patients，46 developed SSI，yielding an incidence rate of 8.66%. Univariate analysis revealed significant associations between SSI and age，history of diabetes mellitus，anemia，ASA score，surgical approach，intraoperative blood loss，and perioperative prophylactic antibiotic use （P<0.05）. Multivariate analysis further identified age≥60 years，diabetes，anemia，ASA score ≥3，open abdominal surgery，and intraoperative blood loss ≥500 mL as independent risk factors for SSI （P<0.05）. Conclusions Advanced age，diabetes，anemia，high ASA score，open abdominal surgery，and significant intraoperative bleeding are key risk factors for SSI in gynecological malignancy patients. Clinical strategies should focus on optimizing perioperative management，including glycemic control，anemia correction，optimization of the surgical approach，and hemorrhage reduction，to decrease infection risks and improve patient outcomes.