结直肠癌患者术后切口感染相关危险因素分析  

Related risk factors for postoperative incision infections in colorectal cancer patients

作　　者：沈忠[1] 裘建明[1] 杨关根[1] 茅伟明[1] 张秀峰[1] 邓群[1] 

机构地区：[1]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》2014年第13期3286-3287,3295,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学青年基金资助项目(81101876/H1617);浙江省医药卫生平台骨干人才基金项目(2011RCA035);浙江省科技厅社会发展基金项目(2012C33097)

摘　　要：目的分析结直肠癌患者根治手术后切口感染的发生情况,探讨引起切口感染的危险因素,以减少感染的发生。方法回顾性分析2005年1月-2011年l2月医院肛肠外科432例行结直肠癌根治手术患者临床资料,以发生切口感染者为感染组,同期无切口感染者为对照组,对可能影响切口感染的因素进行单因素分析和多因素logistic回归分析;数据采用SPSS 17.0软件进行处理。结果 432例患者中发生切口感染51例,感染率1.8%,其中年龄>60岁患者感染率13.0%,直肠癌手术后患者感染率14.5%,采用传统开腹手术患者的感染率14.3%;感染组与对照组相比其体质量指数(BMI)、糖尿病史、手术方式、预防性造口、快速康复的实施等因素差异均有统计学意义(P<0.05),而高BMI、伴有糖尿病、传统开腹手术、未采用快速康复的流程与结直肠癌术后切口感染密切相关(P<0.05)。结论结直肠癌术后切口感染的发生率较高,与多种因素有关,控制体质量和血糖、采用腔镜手术和贯彻快速康复理念是降低术后切口感染的关键。OBJECTIVE To analyze the incidence of incision infections in the colorectal cancer patients after elective radical surgery and explore the risk factors for the incision infections so as reduce the incidence of infections. METHODS The clinical data of 432 colorectal cancer patients who underwent the radical surgery in the department of anorectal surgery from Jan 2005 to Dec 2011 were retrospectively analyzed, then the patients with incision infections were assigned as the infection group, meanwhile the patients without incision infections were set as the con- trol group, the univariate analysis and multivariate logistic regression analysis were performed for the risk factors for the incision infections, and the data were statistically analyzed with the use of SPSS 17.0 software. RESULTS Of the 432 patients, the incision infections occurred in 51 cases with the infection rate of 1.8%; the incidence of infections was 13.0% in the patients aged more than 60 years old, the incidence of postoperative infections was 14.5 % in the patients undergoing colorectal cancer surgery, 14.3 % in the patients undergoing traditional laparot- omy. The difference in the body mass index （BMI）, history of diabetic mellitus, types of surgery, preventive stoma, or implementation of rapid recovery was significant （P〈0.05） ; however, the high BMI, complication of dia- betic mellitus, traditional laparotomy, and implementation of rapid recovery were closely associated with the post- operative incision infections in the colorectal cancer patients （P〈0.05）. CONCLUSION The incidence of postoper- ative incision infections is high in the colorectal cancer patients, which is related to multiple factors; it is the key to control the BMI and level of blood glucose, adopt the laparoscopic surgery, and implement the rapid recovery so as to reduce the incidence of postoperative incision infections.

关 键 词：结直肠癌 切口感染 危险因素 

分 类 号：R619.3[医药卫生—外科学]