ASA评分与手术时间在结直肠癌患者手术部位感染风险评估中的作用

 目的 探讨ASA评分与手术时间在结直肠癌患者手术部位感染（SSI）风险评估中的作用。方法 回顾性收集2018年1月-2019年12月某院结直肠癌手术患者的临床资料，分析患者ASA评分与术后发生SSI的相关性，应用受试者工作特征曲线（ROC曲线）分析检验ASA评分对患者发生SSI的风险评估效能，并比较不同ASA分级下手术时间长短对SSI发病率的影响。结果 共纳入结直肠癌手术患者430例，其中结肠癌手术243例，直肠癌手术187例；男性238例，女性192例。57例患者发生SSI，SSI发病率为13.26%。随着ASA评分的升高，患者SSI发病率逐渐增加。ROC曲线分析显示，ASA评分的曲线下面积为0.706，有统计学意义（P<0.05）。对于中风险ASA评分组，手术时间≥ 180 min的患者SSI发病率高于手术时间<180 min的患者，差异有统计学意义（P<0.05）。结论 ASA评分能够评估结直肠癌患者术后发生SSI的风险，外科医生在术前应重视并改善患者的全身状态，尽可能缩短患者的手术时间，以降低SSI发病率。

Role of ASA score and operation time in risk assessment of surgical site infection in patients with colorectal cancer

Objective To explore the role of ASA score (American Society of Anesthesiologists physical status classification) and operation time in risk assessment of surgical site infection (SSI) in patients with colorectal cancer. Methods Clinical data of patients undergoing colorectal cancer surgery from January 2018 to December 2019 were retrospectively collected, correlation between ASA score and post-operative SSI was analyzed, receiver opera-ting characteristic (ROC) curve was used to test the efficiency of ASA score in risk assessment of patients with SSI, and to compare the effect of length of operation time on SSI under different ASA grades. Results A total of 430 patients undergoing surgery of colorectal cancer were included in study, 243 cases of colon cancer and 187 cases of rectal cancer, 238 males and 192 females. 57 patients had SSI, incidence of SSI was 13.26%. With the increase of ASA score, incidence of SSI in patients gradually increased. ROC curve analysis showed that area under the curve of ASA score was 0.706, which was statistically significant (P<0.05). For the medium-risk ASA score group, incidence of SSI in patients with operation time ≥ 180 minutes was higher than those with operation time<180 minutes, difference was statistically significant (P<0.05). Conclusion ASA score can assess the risk of post-operative SSI in patients with colorectal cancer, surgeons should pay attention to and improve the systemic status of patients before surgery, and shorten the operation time as much as possible to reduce the incidence of SSI.