不同手术模式对胃癌术后医院感染的影响及相关因素分析  

Influence on postoperative nosocomial infections of different operation modes for gastric cancer and related factors

作　　者：吴学辉[1] 李经忠[1] 刘建军[1] 郝永光[1] 张庆民[1] 张婷婷[1] WU Xu-hui LI Jing-zhong LIU Jian-jun HAO Yong-guang ZHANG Qing-min ZHANG Ting-ting(Shengli Oil Field Central Hospital in Dongying, Dongying, Shandong 257099, Chin)

机构地区：[1]东营市胜利油田中心医院肿瘤科,山东东营257099

出　　处：《中华医院感染学杂志》2016年第23期5447-5449,共3页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展计划项目(2014WSA05002)

摘　　要：目的比较两组不同手术模式对胃癌术后医院感染的影响和分析相关影响因素,降低医院感染率和改善胃癌预后。方法选择2014年1月-2015年6月147例经手术治疗的胃癌患者,按手术方式分为研究组82例和对照组65例,分别接受腹腔镜和开腹手术,比较两组患者术后临床指标,数据采用SPSS 17.0软件进行统计分析。结果研究组医院感染率为7.32%,明显低于对照组20.00%,差异有统计学意义(P<0.05);手术后两组CD_3^+、CD_4^+、CD_8^+和CD_4^+/CD_8^+均明显下降,CRP和IL-6均明显升高,与手术前比较,差异均有统计学意义(P<0.05);logistics回归分析显示,CD_4^+/CD_8^+、CRP、IL-6、年龄和临床分期均是医院感染的独立危险因子(P<0.05)。结论腹腔镜手术能明显降低胃癌术后的医院感染率,对免疫功能和机械损伤的影响小可能是其主要原因。OBJECTIVE To compare the influence on postoperative nosocomial infections of two different operation modes for gastric cancer and analyze the related factors,in order to reduce the nosocomial infection rate and improve the prognosis.METHODS A total of 147 patients with gastric cancer after surgical treatment were divided into research group（n=82）and the control group（n=65）during Jan.2014 and Jun.2015,who were received laparoscopy and laparotomy surgery,respectively.The incidence of postoperative indicators was analyzed by SPSS17.0.RESULTS The incidence of postoperative nosocomial infection was 7.32%in research group,significantly lower than the control group of 20.00%（P〈0.05）.In both two groups after the operation the levels of CD3＋,CD4＋,CD8＋and CD4＋/CD8＋decreased obviously,and CRP and IL-6were significantly elevated,compared to pre-operation（P〈0.05）.Logistics regression analysis showed that CD4＋/CD8＋,CRP,IL-6,age and clinical stage were independent risk factors of nosocomial infection（P〈0.05）.CONCLUSION Laparoscopic surgery can significantly reduce the nosocomial infection rate of postoperative gastric cancer.Less impact for immune function and mechanical damage may be the main reason for it.

关 键 词：胃癌 腹腔镜 开腹手术 医院感染 

分 类 号：R656.61[医药卫生—外科学]