急性肠梗阻患者急诊术后切口感染的危险因素及病原体分析  

Risk factors and pathogens of wound infectionin patients with acute intestinal obstruction after emergency operation

作　　者：汪燕[1] 杜小宜 徐继宗[1] 龚江波[1] 

机构地区：[1]三峡大学肛肠病诊疗研究所湖北省宜昌市第二人民医院结直肠肛门科,湖北443000 [2]三峡大学肛肠病诊疗研究所湖北省宜昌市第二人民医院麻醉科,湖北443000

出　　处：《中华结直肠疾病电子杂志》2017年第3期194-197,共4页Chinese Journal of Colorectal Diseases(Electronic Edition)

摘　　要：目的探讨急性肠梗阻患者急诊术后切口感染病原菌及危险因素。方法选取2013年1月至2016年5月湖北省宜昌市第二人民医院行急诊手术治疗的急性肠梗阻患者193例,其中术后出现切口感染者39例(感染组),未出现切口感染者154例(对照组),感染组切口脓性分泌物进行病原菌检测,比较两组临床资料。结果 39例术后切口感染者,其中单细菌感染24例(61.54%),两种细菌感染12例(30.77%),三种细菌感染3例(7.69%);共发现57株细菌,主要为大肠埃希菌、肺炎克雷伯菌等。感染组年龄≥60岁的比例、Ⅲ类切口的比例、手术时间≥120 min的比例、血运性肠梗阻比例和糖尿病比例分别为58.97%、51.28%、56.41%、12.82%和82.05%,明显高于对照组,差异有统计学意义(χ~2=9.812、14.710、10.718、9.258和35.187,P均<0.05);感染组和对照组性别、病程、粘连性肠梗阻比例、结直肠肿瘤比例和粪石性肠梗阻比例比较差异无统计学意义(χ~2=1.786、t=-0.385、χ~2=0.000、χ~2=0.000和χ~2=2.792,P均>0.05);Logistic回归分析,结果显示:年龄≥60岁,合并糖尿病、Ⅲ类切口和手术时间>120 min是急性肠梗阻患者术后切口感染的危险因素(OR=6.184、22.220、7.807和1.721,P均<0.05)。结论针对急性肠梗阻患者术后切口感染的危险因素,应采取多种措施来降低感染的发生。Objective To investigate risk factors and pathogens of wound infectionin patients with acute intestinal obstruction after emergency operation. Methods From January 2013 to May 2016, 193 cases of acute intestinal obstruction were treated by emergency operation in Yichang Second People＇s Hospital of Hubei Province.There were 39 cases of incision infection （infection group） and 154 cases of non incision infection （control group）.The pathogenic bacteria were detected in the infected group, and compared the clinical data of the two groups. Results In the thirty-nine cases of incision infection after operation, one kind of bacterial infections in 24 cases （61.54%）, two kind of bacterial infections in 12 cases （30.77%）, three kinds of bacterial infections in 3 cases （7.69%）. Fifty-seven kinds of bacteria were mainly Escherichia coli, Klebsiella pneumoniae, etc. In the observation group, -〉 60 years old proportion, the proportion of III class incision, operation time 〉- 120 min, the proportion of blood obstruction and diabetes rates were 58.97%, 51.28%, 56.41%, 12.82% and 82.05%, significantly higher than the control group, the difference was statistically significant （2=9.812, 14.710, 10.718, 9.258 and 35.187, P 〈 0.05）. The proportion of sex, duration of disease, the proportion of intestinal obstruction, the proportion of colorectal tumor proportion and the proportion of fecal obstruction in the infection group and control group were not statistically significant （2=1.786, t=-0.385, 2=0.000, 2=0.000 and 2=2.792,P 〉 0.05）.The results of Logistic regression analysis showed： age, -〉 60 years, diabetes mellitus, III class incision and the operation time -〉 120 rain were risk factors of incision infection with acute intestinal obstruction after operation （OR=6.184, 22.220, 7.807 and 1.721, P 〈 0.05）.Conclusion In view of the risk factors of postoperative wound infection in patients with acute intestinal obstruction, we should take various measures to reduce the incidence of

关 键 词：肠梗阻 外科手术 切口感染 危险因素 病原体 

分 类 号：R656[医药卫生—外科学]