胃肠肿瘤患者手术切口感染调查分析  

Investigation analysis of surgical incision infections in patients with gastrointestinal tumors

作　　者：李大伟[1] 王非[1] 祝智军[1] 

机构地区：[1]浙江省中医院普外科,浙江杭州310018

出　　处：《中华医院感染学杂志》2014年第1期148-150,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金项目(2012kyb143)

摘　　要：目的调查分析胃肠肿瘤患者手术切口感染率、病原菌构成、抗菌药物敏感率及感染危险因素,根据调查结果制定科学的防治措施。方法回顾性分析2008年1月-2012年11月普外科596例胃肠肿瘤患者术后切口感染情况,汇总分析感染病原菌构成及抗菌药物敏感率。结果切口感染患者61例,感染率10.23%,共分离出病原菌58株,其中革兰阴性菌47株占81.03%,革兰阳性菌8株占13.79%,真菌3株占5.17%;革兰阴性菌及革兰阳性菌均对万古霉素敏感,敏感率为100.00%,白色假丝酵母菌对酮康唑、氟康唑、两性霉素B及制霉菌素敏感率为100.00%;logistic回归分析发现切口感染与年龄、糖尿病、肿瘤类型、白蛋白水平、手术类型、切口类型、切口长度、手术时间及住院时间因素有关(P<0.05)。结论切口感染是胃肠肿瘤患者术后常见并发症,高危患者发生率更高,需针对性采取防治措施以降低感染率。OBJECTIVE To investigate the incidence of surgical incision infections in the patients with gastrointestinal tumors,distribution of pathogens,drug susceptibility rates,and risk factors for infections so as to put forward scientific prevention measures.METHODS Totally 596cases of patients with gastrointestinal tumors,who were treated in the department of general surgery from Jan 2008 to Nov 2012,were enrolled in the study,then the incidence of postoperative incision infections was retrospectively analyzed,and the distribution of pathogens causing infections and the drug susceptibility rates were observed.RESULTS The incision infections occurred in 61cases with the infection rate of 10.23%.A total of 58strains of pathogens have been isolated,including 47（81.03%） strains of gram-negative bacteria,8（13.79%）strains of gram-positive bacteria,and 3（5.17）strains of fungi. The gram-negative bacteria and gram-positive bacteria were highly susceptible to vancomycin with the drug susceptibility rate of 100.0%;the drug susceptibility rates of the Candida albicans to ketoconazole,fluconazole,amphotericin B,and nystatin were 100.0%.The logistic regression analysis indicated that the incidence of incision infections was related to the age,diabetic mellitus,types of tumor,level of albumin,types of surgery,types of incision,length of incision,operation duration,and length of hospital stay（P0.05）.CONCLUSIONThe incision infection is a common postoperative complication of the patients with gastrointestinal tumors,and the incidence of incision infections are higher in the high-risk patients,thus the targeted prevention measures should be taken to reduce the infection rate.

关 键 词：胃肠肿瘤 切口感染 危险因素 

分 类 号：R619.3[医药卫生—外科学]