直肠癌患者术后切口感染的相关危险因素分析  

Related risk factors for postoperative incision infections in colorectal cancer patients

作　　者：胡森懋[1] 李善平[1] 卢菊芳[2] 张华[1] 陆海燕[1] 

机构地区：[1]三峡大学仁和医院结直肠肛门外科,湖北宜昌443001 [2]三峡大学仁和医院检验科,湖北宜昌443001

出　　处：《中华医院感染学杂志》2016年第17期4026-4028,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅青年科技人才基金资助项目(QJX2012-04)

摘　　要：目的探讨直肠癌患者术后引起切口感染的相关影响因素,为临床有效预防控制直肠癌患者术后切口感染提供依据。方法选择2013年2月-2015年2月手术治疗的98例直肠癌患者为研究对象,分析患者术后切口感染率、病原菌分布及药敏结果,并分析术后切口感染的相关因素。结果 98例患者中发生切口感染20例,感染率20.41%,共检出病原菌26株,其中革兰阳性菌10株占38.46%,革兰阴性菌15株占57.69%,真菌1株占3.85%;铜绿假单胞菌及大肠埃希菌对亚胺培南、美罗培南的耐药率较低,表皮葡萄球菌及金黄色葡萄球菌对万古霉素、替考拉宁的耐药率较低;术前抗菌药使用时间>3d、伴有糖尿病、手术持续时间>150min、开腹手术为直肠癌患者术后切口感染的相关因素。结论直肠癌患者术后切口感染的相关因素较多,医务人员应规范操作,尽可能缩短手术时间,合理应用抗菌药物进行感染预防,积极有效的控制患者血糖及体质量,从而有效预防直肠癌患者术后切口感染的发生。OBJECTIVE To explore the related influencing factors for postoperative incision infections in colorectal cancer patients so as to provide guidance for effective prevention and control of the postoperative incision infections in the colorectal cancer patients.METHODS A total of 98 colorectal cancer patients who received surgical procedures from Feb 2013 to Feb 2015 were recruited as the study objects,then the incidence of postoperative incision infections,distribution of pathogens,and results of drug susceptibility testing were observed,and the related factors for the postoperative incision infections were analyzed.RESULTS The incision infections occurred in 20 of 98patients,with the infection rate 20.41%.Totally 26 strains of pathogens were isolated,including 10（38.46%）strains of gram-positive bacteria,15（57.69%）strains of gram-negative bacteria,and 1（3.85%）strain of fungus.The drug resistance rates of the Pseudomonas aeruginosa and Escherichia coli to imipenem and meropenem were relatively low;the drug resistance rates of the Staphylococcus epidermidis and Staphylococcus aureus to vancomycin and teicoplanin were relatively low.The related factors for the postoperative incision infections in the colorectal cancer patients included the time of preoperative use of antibiotics more than 3days,complication with diabetic mellitus,operation duration more than 150 min,and laparotomy.CONCLUSIONThere are a variety of related factors for the postoperative incision infections in the colorectal cancer patients.It is necessary for the health care workers to carry out standard operations,try to shorten the operation duration as much as possible,reasonably use antibiotics for prevention of infections,and actively control the blood glucose and body mass so as to effectively prevent the postoperative incision infections in the colorectal cancer patients.

关 键 词：术后切口感染 直肠癌 影响因素 预防措施 

分 类 号：R657.1[医药卫生—外科学]