肠梗阻导管对结直肠癌合并肠梗阻患者术后感染的影响

目的探究肠梗阻导管对结直肠癌合并肠梗阻患者术后感染并发症发生率的影响。方法选择2015年2月-2019年10月上饶市立医院收治的235例结直肠癌合并肠梗阻患者作为研究对象,根据是否应用肠梗阻导管将患者分为两组,对照组102例患者行急诊结直肠癌肿瘤切除术,研究组133例患者行肠梗阻导管置入术后择期行根治术。收集患者围手术期指标及并发症发生情况,对术后感染患者进行病原菌分析。结果研究组患者全部行择期一期吻合术,且24 h症状缓解率96.99%显著高于对照组的11.76%(P<0.05);研究组患者术后排气时间(3.22±1.01)h、住院时间(11.23±2.13)d均较对照组缩短(P<0.05);研究组切口感染4.51%(6/133)、总感染率7.52%(10/133)和低钠低钾蛋白血症发生率30.08%(40/133)均低于对照组(P<0.05);29例感染患者共分离出46株病原菌,其中革兰阴性菌28株,占60.87%,革兰阳性菌17株,占36.96%,真菌1例,占2.17%。结论梗阻性导管置入后择期手术术后恢复较快,可降低结直肠癌合并肠梗阻患者术后感染并发症发生率,有较高的临床应用价值。

Impact of intestinal obstruction catheter on postoperative infection in colorectal cancer patients complicated with intestinal obstruction

OBJECTIVE To explore the impact of intestinal obstruction catheter on incidence of postoperative infection in the colorectal cancer patients complicated with intestinal obstruction.METHODS A total of 235 colorectal cancer patients complicated with intestinal obstruction who were treated in Shangrao Municipal Hospital from Feb 2015 to Oct 2019 were recruited as the study subjects and were divided into two groups according to the status of use of intestinal obstruction catheter.102 patients of the control group underwent emergency rectal cancer tumor resection,and 133 patients of the study group underwent elective radical surgery after intestinal obstruction catheterization.The perioperative indexes and incidence of complications were collected,and the pathogens isolated from the patients with postoperative infection were observed.RESULTS All of the patients in the study group underwent elective stageⅠanastomosis,the 24-hour remission rate of symptoms of the study group was 96.99%,significantly higher than 11.76%of the control group(P<0.05).The postoperative exhaust time and length of hospital stay of the study group were respectively(3.22±1.01)hours and(11.23±2.13)days,significantly shorter than those of the control group(P<0.05).The incidence of incision infection,total incidence rate of infection and incidence rate of hyponatremia hypokalemia of the study group were respectively 4.51%(6/133),7.52%(10/133)and 30.08(40/133),significantly lower than those of the control group(P<0.05).Totally 46 strains of pathogens were isolated from the 29 patients with infection,28(60.87%)of which were gram-negative bacteria,17(36.96%)were gram-positive bacteria,and 1(2.17%)was fungus.CONCLUSION The patients who receive elective surgery after intestinal obstruction catheterization recover more quickly,it can reduce the incidence of postoperative infectious complications in the colorectal cancer patients complicated with intestinal obstruction and has high clinical application value.