结直肠癌患者手术部位感染病原菌分布与危险因素分析  

Distribution of pathogens causing surgical site infections in colorectal cancer patients and related risk factors

作　　者：蔡尚党[1] 张龙江[1] 王海颖[2] 安玉会[3] 郭艳萍[4] 

机构地区：[1]河南省中医院肛肠科,河南郑州450002 [2]河南省中医院检验科,河南郑州450002 [3]郑州大学医学院生化教研室,河南郑州450052 [4]河南省人民医院病理科,河南郑州450003

出　　处：《中华医院感染学杂志》2016年第4期862-864,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金青年基金资助项目(81001632)

摘　　要：目的分析结直肠癌患者手术部位感染的病原菌分布及相关危险因素,为临床干预提供参考依据。方法收集2012年1月-2015年1月在河南省中医院诊治的结直肠癌患者284例临床资料,对手术部位送检标本进行病原菌培养与鉴定,分析患者手术部位感染的病原菌分布及相关危险因素。结果 284例患者发生感染80例,感染率为28.17%;共检出病原菌94株,其中大肠埃希菌43株占45.74%、金黄色葡萄球菌11株占11.70%、粪肠球菌9株占9.57%;经过多元logistic回归分析后发现,合并糖尿病、未进行腹腔镜手术以及手术持续时间≥3h均是患者手术部位发生感染的独立危险因素,差异有统计学意义(P<0.05)。结论导致结直肠癌患者手术部位感染的病原菌主要为大肠埃希菌,应重点防范影响感染的危险因素,以降低感染率。OBJECTIVE To investigate the distribution of pathogens causing surgical site infections in the colorectal cancer patients and analyze the related risk factors so as to provide guidance for clinical intervention.METHODS The clinical data were collected from 284 colorectal cancer patients who were treated in Henan Traditional Chinese Medicine Hospital from Jan 2012 to Jan 2015,the blood specimens of the surgical sites were cultured for pathogens,the distribution of the pathogens causing the surgical site infections was observed,and the related risk factors were analyzed.RESULTS Of the 284 patients,80had the infections with the infection rate of 28.17%.A total of 94 strains of pathogens were isolated,of which 43（45.74%）were Escherichia coli,11（11.70%）were Staphylococcus aureus,and 9（9.57%）were Enterococcus faecalis.The multivariate logistic regression analysis showed that the independent risk factors for the surgical site infections included the complication of diabetic mellitus,laparoscopic surgery,and operation duration no less than 3hours（P0.05）.CONCLUSION The E.coli is dominant among the pathogens causing the surgical site infections in the colorectal cancer patients.It is necessary to focus on the prevention of the risk factors for the infections so as to reduce the infection rate.

关 键 词：结直肠癌 手术部位感染 病原菌 分布 危险因素 

分 类 号：R619.3[医药卫生—外科学]