结直肠癌患者术后切口感染危险因素分析

目的结直肠癌手术切口感染会导致病情加重和愈合时间延长,本研究分析结直肠癌患者术后切口感染危险因素,为制定相关防治措施提供参考。方法回顾性分析2014-01-01-2018-12-30河北医科大学第一医院普通外科接受手术治疗的282例结直肠癌患者临床资料,分析感染患者手术切口感染的相关因素和病原菌构成。结果术后切口感染17例,感染率为6.03%(17/282);开腹手术切口感染率为10.58%(11/104),腹腔镜手术切口感染率为3.37%(6/178),差异有统计学意义,P<0.05。17例切口感染者中共检出18株病原菌,革兰阳性菌6株(33.33%),革兰阴性菌10株(55.56%),真菌2株(11.11%)。单因素分析显示,结直肠癌患者术后切口感染与手术方式、患者年龄、体质量指数(body mass index,BMI)、切口长度、手术时间、是否合并糖尿病有关,均P<0.05;与患者性别、Duke分期、手术部位和术中出血量无关,均P>0.05。Logistic回归分析显示,年龄>60岁、BMI>24kg/m2、有糖尿病是结直肠癌患者术后切口感染的危险因素。结论结直肠癌患者术后切口感染的发生与手术方式、患者年龄、BMI、切口长度、手术时间、是否合并糖尿病有关,应采取针对性的防治措施,以降低结直肠癌患者术后切口感染的发生。

Risk factors analysis of incision infection in patients with colorectal cancer after surgery

OBJECTIVE To analyze the risk factors of postoperative incisional infection in colorectal cancer patients,and provide reference for the establishment of related prevention and treatment measures.METHODS Totally282 patients undergoing surgical treatment of gastrointestinal surgery in our hospital were retrospectively analyzed,and the relevant factors and the pathogenic composition ratio of surgical site infection in infected patients were detected.RESULTS Among the 282 patients with colorectal cancer,17 cases were infected with postoperative incision,the infection rate was 6.03%.The open surgery incision infection rate was 10.58%(11/104),the laparoscopic surgery incision infection rate was 3.37%(6/178),P<0.05.Totally 18 pathogenic bacteria were detected in 17 cases with infected incisions,among them the gram-positive bacteria were 6 strains(33.33%),gram-negative bacteria were 10 strains(55.56%),and fungi were 2 strains(11.11%).Single factor analysis revealed,postoperative incision infection in patients with colorectal cancer was related to the surgical approach,age,BMI,incision length,operation time and diabetes(P<0.05).It was not related to the patient’s gender,Duke stage,surgical site and intraoperative blood loss(P>0.05).Logistic regression analysis showed that age>60 years old,BMI>24 kg/m^2 and diabetes were risk factors for postoperative incision infection in colorectal cancer patients.CONCLUSION Postoperative incision infection in patients with colorectal cancer is related to the surgical approach,age,BMI,incision length,operation time and diabetes as well as the measures to reduce postoperative wound infection in patients with colorectal cancer.