肝包虫病患者手术部位感染危险因素的logistic回归分析

 目的 分析肝包虫病患者手术部位感染的危险因素。方法 选取2017年1月-2020年12月在青海省人民医院接受肝包虫病手术治疗的患者,根据是否发生手术部位感染分为感染组和对照组。回顾性分析患者病历资料,采用单因素和多因素logistic回归分析,分析肝包虫病患者手术部位感染的危险因素。结果 共纳入681例患者,发生手术部位感染59例,感染率为8.66%,其中切口感染23例,腹腔感染28例,切口+腹腔感染6例,膈下感染2例。感染患者共分离出63株病原菌,其中革兰阴性菌占63.49%,革兰阳性菌占34.92%。主要以铜绿假单胞菌、鲍曼不动杆菌和粪肠球菌为主,分别占17.46%、9.53%和7.94%。多因素logistic回归分析显示,合并糖尿病、有肝包虫病手术史、术后胆漏、引流管留置时间≥ 15 d、手术时间≥ 250 min是肝包虫病患者手术部位感染的独立危险因素(均P<0.05)。结论 肝包虫病患者手术部位感染危险因素较多,围手术期及术后积极控制血糖、尽可能避免肝包虫病复发从而减少肝包虫病手术史,积极预防术后胆漏,缩短手术时间,以及减少引流管留置时间等在预防肝包虫病手术部位感染中可起积极作用。

Logistic regression analysis on risk factors for surgical site infection in patients with hepatic hydatidosis

Objective To analyze the risk factors for surgical site infection(SSI)in patients with hepatic hydatidosis.Methods Patients who underwent surgery for hepatic hydatidosis in Qinghai Provincial People’s Hospital from January 2017 to December 2020 were selected,according to whether there was SSI,they were divided into infection group and control group.Medical data of patients were analyzed retrospectively,risk factors for SSI in patients with hepatic hydatidosis were analyzed by univariate and multivariate logistic regression analysis.Results A total of 681 patients were included,there were 59 cases of SSI,with an infection rate of 8.66%,including 23 cases of incisional infection,28 cases of abdominal infection,6 cases of incisional+abdominal infection and 2 cases of subphrenic infection.A total of 63 strains of pathogens were isolated from infected patients,Gram-negative and Gram-positive bacteria accounted for 63.49%and 34.92%respectively.Pseudomonas aeruginosa,Acinetobacter baumannii and Enterococcus faecalis accounted for 17.46%,9.53%and 7.94%respectively.Multivariate logistic regression analysis showed that diabetes mellitus,history of surgery for hepatic hydatidosis,post-operative bile leakage,indwelling time of drainage tube≥15 days,and duration of surgery≥250 minutes were independent risk factors for SSI in patients with hepatic hydatidosis(all P<0.05).Conclusion There are multiple risk factors for SSI in patients with hepatic hydatidosis,actively controlling blood glucose during and after surgery,avoiding the recurrence of hepatic hydatidosis as much as possible to reduce the surgery for hepatic hydatidosis,actively preventing post-operative bile leakage,shortenning operation time and reducing the indwelling time of drainage tube can play a positive role in the prevention of SSI.