不同手术方式对直肠癌术后感染患者病原菌与免疫功能影响分析  

Pathogens causing postoperative infections in colorectal cancer patients undergoing different surgical procedures and impact on immune function

作　　者：任鹏涛[1] 张苑[2] 闫庆辉[1] 张国建[1] 林林[1] 

机构地区：[1]河北医科大学第二医院肛肠外科,河北石家庄050000 [2]河北医科大学第二医院心电图室,河北石家庄050000

出　　处：《中华医院感染学杂志》2014年第4期965-967,共3页Chinese Journal of Nosocomiology

基　　金：河北省卫生厅医药卫生类科研基金项目(20110627)

摘　　要：目的探讨直肠癌患者进行不同手术方式术后感染及对免疫功能的影响,为直肠癌患者选择手术方法提供有效地参考。方法对2009年4月-2013年11月收治的直肠癌手术治疗患者114例进行统计分析,依据患者采用治疗方式不同将其分为开腹手术组56例和腹腔镜组58例,对上述患者进行术后感染、病原菌分布以及患者免疫功能进行比较,数据均采用SPSS19.0软件进行统计分析。结果开腹手术组患者中术后感染22例,感染率为39.3%;腹腔镜组患者中术后感染16例,感染率为27.6%;开腹手术组患者感染部位分离出病原菌51株,其中革兰阳性菌16株占31.4%,革兰阴性菌30株占58.8%;腹腔镜组患者感染部位分离出病原菌39株,其中革兰阳性菌11株占28.2%,革兰阴性菌24株占61.5%;两组患者手术后直肠癌患者较术前干扰素-γ(IFN-γ)、白介素2(IL-2)明显升高,而患者体内白介素10(IL-10)水平则明显降低,差异均有统计学意义(P<0.05),但组间比较差异无统计学意义。结论直肠癌患者应用腹腔镜手术方式治疗,术后感染率、病原菌检出率均优于开腹手术治疗组,且在提高患者免疫能力上也有一定优势。OBJECTIVE To explore the incidence of postoperative infections in the colorectal cancer patients undergoing different surgeries and the influence on immune function so as to choose effective surgery for the colorectal cancer patients. METHODS A total of 114 colorectal cancer patients, who underwent surgeries in the hospital from Apt 2009 to Nov 2013, were statistically analyzed and divided into the open surgery group with 56 cases and the laparoscopy group with 58 cases according to the surgery mode, then the incidence of postoperative infections, distribution of pathogens, and immune function were observed and compared, and the data were statistically analyzed with the use of SPSS19.0 software. RESULTS The postoperative infections occurred in 22 cases in the open surgery group with the infection rate of 39.3~ and in 16 cases in the laparoscopy group with the infection rate of 27.6~. Totally 51 strains of pathogens have been isolated from the infection sites of the patients in the open surgery group, including 16 （31.4~//00） strains of gram-positive bacteria and 30 （58.8~） strains of gram-negative bacteria~ while 39 strains of pathogens have been isolated from the infection sites of the patients in the laparoscopy group, including 11 （28.2~） strains of gram-positive bacteria and 24 （61.5~/oo） strains of gram- negative bacteria. The levels of the interferon-~＇（IFN-＇/） and interleukin-2 （IL-2） were significantly elevated after the surgery, but the level of the interleukin-10 （IL-10） was significantly reduced, the differences were statistically significant（P ~ 0. 05）, however, the differences between the groups were not statistically significant. CONCLUSION The laparoscopy is superior to the open surgery for the colorectal cancer patients, with the incidence of postoperative infections lower, the detection rate of pathogens lower, which has certain advantage inimproving the immune unction.

关 键 词：直肠癌 术后感染 免疫功能 

分 类 号：R619.3[医药卫生—外科学]