结直肠癌患者术后切口感染与手术相关因素分析  

Related factors for postoperative incision infections in colorectal cancer patients

作　　者：郑学聪[1] 苏志明[1] 王长庭[1] 

机构地区：[1]福建医科大学附属第二医院普外科,福建泉州362000

出　　处：《中华医院感染学杂志》2014年第13期3288-3289,3292,共3页Chinese Journal of Nosocomiology

基　　金：福建医科大学附属二院苗圃基金项目(2012MP20)

摘　　要：目的探讨结直肠癌患者术后切口感染与手术的相关因素,以便更好地降低术后切口感染率。方法选择2007年1月1日-2012年12月31日住院择期行结直肠癌手术的患者373例,应用成组病例对照研究方法进行研究;数据采用SPSS16.0软件进行统计分析。结果经单因素分析发现,切口感染率:年龄≥60岁为13.56%、<60岁为6.57%,开腹手术为16.47%、腔镜手术为6.40%,手术有皮下缝合为9.27%、无皮下缝合为20.00%,可吸收缝合线为8.49%、丝缝合线为16.67%,甲硝唑冲洗切口为8.23%、生理盐水冲洗为15.49%,以上二者对比差异均有统计学意义(P<0.05);而性别、抗菌药物使用时间、手术部位、缝合方式经对比分析,均对术后切口感染的影响无相关(P>0.05);进一步logistic回归分析,年龄、手术方式、切口冲洗与术后切口感染显著相关(P<0.05)。结论结直肠癌手术因素在术后切口感染起着非常重要的作用,切口感染是多因素作用下的结果,要重视预防术后切口感染,在术后关腹时,做好每一个手术步骤,降低术后切口感染率。OBJECTIVE To explore the related factors for postoperative incision infections in colorectal cancer patients so as to reduce the incidence of postoperative incision infections. METHODS A total of 373 colorectal cancer patients who were hospitalized for elective surgery from Jan 1,2007 to Dec 31, 2012 were enrolled in the study, then the grouped case-control study was conducted, and the statistical analysis was performed with the use of SPSS16.0 software. RESULTS The univariate analysis showed that the incidence of incision infections was 13.56 in the patients with no less than 60 years of age, 6.57% in the patients with less than 60 years of age, 16.47% in the patients undergoing laparotomy 16.47%, 6.40% in the patients undergoing endoscopy, 9.27% in the patients with subcutaneous sutures, 20.00% in the patients without sutures, 8. 49% in the patients with absorbable su- tures, 16.67% in the patients with silk sutures, 8.23% in the patients with incision flushing with metronidazole, 15.49 % in the patients with normal saline,＇ as compared with all the factors above, the differences were statistical- ly significant （P〈0.05）, however, the comparative analysis indicated that the postoperative incision infections were not related to the gender, time of use of antibiotics, surgical site, or suture mode （P〈0.05） ; the logistic re- gression analysis showed that the age, surgery mode, and incision fiushing were significantly related to the postop- erative incision infections （P〈0.05）. CONCLUSION The surgical factors play an important role in the pathogenesis of postoperative incision infections in the colorectal cancer patients, and there are multiple factors for the incision infections. It is necessary to pay attention to the prevention of postoperative incision infections and perform every surgical procedure carefully for abdominal closure so as to reduce the incidence of postoperative incision infections.

关 键 词：结直肠癌 切口感染 手术因素 

分 类 号：R619.3[医药卫生—外科学]