乳腺癌患者术后切口感染危险因素及不同敷贴对其愈合效果评价  

Risk factors of postoperative incisional infections in patients with breast cancer and evaluation of the effect of different dressings on healing

作　　者：谭翠莲[1] 汪德清[2] 邱丽[1] 游多多 廖艳敏 

机构地区：[1]湖北医药学院附属随州医院普外科,湖北随州441300 [2]湖北医药学院附属随州医院耳鼻喉科,湖北随州441300

出　　处：《中华医院感染学杂志》2017年第14期3263-3266,共4页Chinese Journal of Nosocomiology

基　　金：湖北省卫计委基金资助项目(JX6B128)

摘　　要：目的研究影响乳腺癌患者术后切口感染的危险因素,并对患者术后的切口给予不同的敷料,对愈合效果进行评价。方法选择2012-2015年于医院行乳腺癌治疗的1 680例患者基本情况,对发生感染患者进行多因素分析,发生术后切口感染的患者分为3组,各14例,感染Ⅰ组给予常规无菌纱布敷贴,感染Ⅱ组给予银离子藻酸盐抗菌敷贴,感染Ⅲ组患者给予康惠尔伤口护理敷料治疗,分析不同敷贴对患者术后切口的愈合效果。结果1 680例乳腺癌患者,其中术后发生切口感染的患者42例,感染率为2.5%;多因素Logistic分析显示,合并基础疾病,手术方式为根治术,病理类型为浸润癌,乳腺癌发生转移及患者切口引流天数≥10d是乳腺癌患者术后切口感染发生的独立危险因素(P<0.05);患者不同的敷贴治疗,其在各时间段上,感染Ⅲ组的患者治疗效果显著优于其他两组患者(P<0.05)。结论乳腺患者术后切口发生感染的危险因素较多,患者术后使用康惠尔伤口敷料可明显改善切口局部的高渗状态,这对于抑制切口处细菌的繁殖,改善细胞代谢、提高患者皮肤抵抗力以及促进伤口愈合作用显著。OBJECTIVE To explore the risk factors of postoperative incisional infections in patients with breast cancer,and to provide different dressings for postoperative incision of patients,and evaluate the healing effect of different dressings on incisional infections.METHODS A total of 1680 patients with breast cancer from 2012to2015 were selected,and multivariate analysis was carried out in infected patients.The patients were divided into three groups,with 14 cases in each group.The infection group I was treated with conventional sterile gauze paste,the infection group II was treated with silver ion alginate antibacterial paste,and the infection group III was treated with Convall wound dressings,and the healing effects of different dressings were evaluated.RESULTS Of the1680 cases of breast cancer,42 were infected by incisional infections,and the infection rate was 2.5%.Multivariate logistic analysis showed that,patients with underlying diseases,surgical types of radical surgery,pathological types of invasive carcinoma,breast cancer metastasis and patients with incision drainage time≥10dwere independent risk factors for postoperative incisional infections in patients with breast cancer（P〈0.05）.The treatment effect of infection group III was significantly better than that of the other two groups treated with different dressings at each time period（P〈0.05）.CONCLUSION There are a variety of risk factors for the postoperative incision infections in the breast cancer patients.The use of Convall wound dressing can improve the local incision osmotic state,which can significantly inhibit the propagation of inhibition at the incision,improve cell metabolism,improve skin resistance and promote the healing of the wound.

关 键 词：乳腺癌 切口感染 危险因素 敷贴 预防效果 

分 类 号：R737.9[医药卫生—肿瘤]