结直肠癌患者术后感染的危险因素及病原菌分布情况分析  

Risk factors for postoperative infections in patients with colorectal cancer and distribution of pathogens

作　　者：张德重[1] 王丽丽[2] 陈炳合[1] 孙培胜[1] 房祥杰[1] 闫争强[1] 张彬[3] ZHANG De-zhong WANG Li-li CHEN Bing-he SUN Pei-sheng FANG Xiang-jie YAN Zheng-qiang ZHANG Bin(First Affiliated Hospital of Xinxiang Medical College, Xinxiang, Henan 453100, China)

机构地区：[1]新乡医学院第一附属医院胃肠外科,河南新乡453100 [2]新乡医学院第一附属医院重症医学科,河南新乡453100 [3]新乡医学院第一附属医院肝胆外科,河南新乡453100

出　　处：《中华医院感染学杂志》2017年第5期1105-1108,共4页Chinese Journal of Nosocomiology

基　　金：河南省科技厅重点科技攻关基金资助项目(2014200340)

摘　　要：目的探讨结直肠癌患者术后感染的危险因素并分析其病原菌分布情况。方法针对性别、年龄、体质量指数(BMI)、是否吸烟、手术方式、手术时间、导尿管留置时间、住院时间、是否合并糖尿病、腹部手术史等对2013年6月-2015年5月548例结直肠癌术后感染患者的相关因素进行分析,并通过Logistic回归分析探讨结直肠癌患者术后感染的危险因素,同时根据病原菌检测结果分析病原菌分布。结果 548例结直肠癌患者术后感染93例占16.97%,患者在年龄、BMI、吸烟、手术方式、手术时间、导尿管留置时间、住院时间、合并糖尿病方面差异有统计学意义(P<0.05或P<0.01);Logistic回归示:高龄、吸烟、导尿管留置时间长、住院时间长、合并糖尿病均为结直肠癌患者术后感染的独立危险因素(P<0.05);检出病原菌243株,以大肠埃希菌、金黄色葡萄球菌最为常见。结论结直肠癌患者术后感染率较高,其病原菌主要为大肠埃希菌和金黄色葡萄球菌,高龄、吸烟、导尿管留置时间长、住院时间长、合并糖尿病为结直肠癌患者术后感染的独立危险因素。OBJECTIVE To explore the risk factors for postoperative infections in patients with colorectal cancer and analyze the distribution of pathogens. METHODS From Jun 2013 to May 2015, a total of 548 colorectal cancer pa- tients who had the postoperative infections were enrolled in the study, then the related factors for the postopera- tive infections, including gender, age, body mass index （BMI）, smoking, surgery mode, operation duration, uri- nary catheter indwelling time, length of hospital stay, complication with diabetic mellitus, and history of abdomi- nal surgery, were analyzed, the risk factors for the postoperative infections in the colorectal cancer patients were explored by means of logistic regression analysis, meanwhile, the distribution of pathogens was observed based on the results of detection of pathogens. RESULTS Of the 548 patients with colorectal cancer, 93 had the postopera- tive infections, accounting for 16. 97%. There was significant difference in the age, BMI, smoking, surgery mode, operation duration, urinary catheter indwelling time, length of hospital stay, or complication with diabetic mellitus （P〈0.05 or P〈0.01）. The logistic regression analysis indicated that the independent risk factors for the postoperative infections in the colorectal cancer patients included advanced age, smoking, long time of urinary catheter indwelling, and complication with diabetic mellitus （P〈0.05）. Totally 243 strains of pathogens were iso- lated, among which Escherichia coli and Staphylococcus aureus were dominant. CONCLUSION The incidence rate of postoperative infections is high in the eoloreetal cancer patients. E. coli and S. aureus are the major species of pathogens. The independent risk factors for the postoperative infections in the colorectal cancer patients include the advanced age, smoking, long time of urinary catheter indwelling, and complication with diabetic mellitus.

关 键 词：结直肠癌 术后感染 危险因素 病原菌分布 

分 类 号：R735.35[医药卫生—肿瘤]