直肠癌患者术后感染多因素分析  

Multivariate analysis of postoperative infections in colorectal cancer patients

作　　者：黄城鑫[1] 罗静泳[1] 陈燕[1] 周立宇[1] 杨关根[2] 

机构地区：[1]杭州师范大学医学院附属萧山第一医院肛肠外科,浙江杭州311200 [2]杭州市第三人民医院肛肠外科,浙江杭州310009

出　　处：《中华医院感染学杂志》2013年第24期6012-6014,共3页Chinese Journal of Nosocomiology

基　　金：杭州市科技局重点专科专病基金项目(2008033Q07)

摘　　要：目的了解直肠癌患者术后感染的发生情况,探讨分析影响直肠癌患者术后发生感染的相关因素,以降低直肠癌患者术后感染的发生。方法回顾性分析2009年3月-2013年4月86例直肠癌住院患者临床资料,采用SPSS16.0软件对试验数据进行统计分析,用单因素分析及多因素logistic分析方法对直肠癌患者术后发生感染的影响因素进行分析。结果直肠癌术后感染23例,感染率26.7%,其中肺部感染12例、尿道感染6例、盆腔感染3例、切口感染2例;检出革兰阴性菌11株、革兰阳性菌3株、真菌9株,单因素分析发现患者高龄≥65岁、伴有糖尿病等基础疾病、选择传统开腹手术、手术时间≥3h及引流时间≥1周与直肠癌患者发生术后感染有关(P<0.05);多因素logisitic分析结果显示,患者高龄(OR=9.008,P=0.019)、伴有糖尿病等基础疾病(OR=25.601,P=0.012)、手术类型(OR=16.236,P=0.014)、手术时间(OR=13.598,P=0.005)、引流时间(OR=14.327,P=0.008)是直肠癌患者术后感染的危险因素。结论直肠癌患者发生术后感染主要与患者的高龄≥65岁、伴有糖尿病等基础疾病及选择的手术类型、手术时间及引流时间长短有着较为密切的关系,值得临床予以高度重视并进行针对性的干预。OBJECTIVE To understand the incidence of postoperative infections in colorectal cancer patients and explore the related factors for postoperative infections in the colorectal cancer patients so as to reduce the incidence of postoperative infections. METHODS The clinical data of 86 coloreetal cancer patients who were hospitalized from Mar 2009 to Apr 2013 were retrospectively analyzed, then the data of the trial were statistically analyzed with the use of SPSS16.0 software, and the univariate analysis and multivariate logistic regression analysis were performed for the influencing factors for the postoperative infections in the colorectal cancer patients. RESULTS The postoperative infections occured in 23 cases with the infection rate of 26. 7%, among which there were 12 cases of pulmonary infections, 6 cases of urinary tract infections, 3 cases of pelvic infections, and 2 cases of incision infections. Totally 11 strains of gram-negative bacteria, 3 strains of gram-positive bacteria, and 9 strains of fungi have been isolated. The univariate analysis showed that the more than 65 years of age, complication of underlying diseases such as diabetes, selection of conventional laparotomy,, operation duration more than 3 hours, and dm：ation of drainage more than 1 week were the related factors for the postoperative infections in the eolorectal cancer patients （P〈0.05） ; multivariate logistic regression analysis indicated that the advanced age（OR= 9. 008, P = 0. 019）, complication of underlying diseases such as diabetes （OR= 25. 601, P= 0. 012）, types of surgery（OR= 16. 236,P=0. 014）, operation duration （OR=13. 598,P=0. 005）, and duration of drainage（OR= 14. 327,P= 0. 008） were the risk factors for the postoperative infections in the colorectal cancer patients. CONCLUSION The postoperative infections in the colorectal cancer patients are closely related to the more than 65 years of age, complication of underlying diseases such as diabetes, type of surgery, operation duration, and duration of dra

关 键 词：直肠癌 患者 术后 感染 

分 类 号：R619.3[医药卫生—外科学]