老年胃癌患者手术部位感染相关并发症的危险因素分析  

Risk factors for surgical site infections in postoperative elderly gastric cancer patients

作　　者：许洪宝[1] 蔡炜龙[1] 汪伟民[1] 潘杰[1] 张鸣杰[1] 韩春蕃[1] 严强[1] Xu Hongbao;Cai Weilong;Wang Weimin;Pan Jie;Zhang Mingjie;Han Chunfan;Yan Qiang(Department of General Sugery , Huzhou Central Hospital, Huzhou 313000, China)

机构地区：[1]湖州市中心医院普外科,浙江省313000

出　　处：《中华普通外科杂志》2018年第4期276-279,共4页Chinese Journal of General Surgery

摘　　要：目的探讨老年胃癌患者在胃癌根治术后手术部位感染（surgical site infection，SSI）相关并发症的危险因素。方法回顾性分析2009-2016年间湖州市中心医院行胃癌根治术的410例老年胃癌患者的临床资料，通过单因素及多因素分析SSI相关并发症的危险因素。结果410例老年胃癌患者中有50例发生SSI，总发生率为12．2％，其中切口感染19例，发生率为4．6％；器官腔隙感染31例，发生率为7．6％。单因素分析发现，年龄〉75岁（χ^2=5．315，P=0．021）、术前贫血（χ^2=3．983，P=0．046）、NRS2002评分≥3分（χ^2=4．785，P=0．029）、糖尿病（χ^2=5．895，P=0．015）、术前消化道梗阻（χ^2=5．250，P=0．022）、未分化癌（χ^2=4．448，P=0．035）、贲门癌（χ^2=5．265，P=0．022）及联合脏器切除（χ^2=4．165，P=0．041）均与SSI有关。多因素分析发现，高龄（OR=2．422，P=0．016）、糖尿病（χ^2=2．524，P=0．026）、术前梗阻（OR=2．098，P=0．047）及高NRS2002评分（OR=1．969，P=0．043）为SSI的独立危险因素。结论高龄、糖尿病、术前梗阻及高NRS2002评分是老年胃癌患者术后SSI的高危因素。Objective To investigate the risk factors of surgical site infection （SSI） related complications after radical gastrectomy for gastric cancer in elderly patients. Methods The clinical data of 410 elderly patients with gastric cancer who underwent radical gastrectomy was retrospectively collected from 2009 to 2016. Univariate and muhivariate analysis were performed to investigate the risk factors of SSI related complications, and the impact of SSI on short-term prognosis. Results SSI developed in 50 out of 410 elderly patients who underwent radical gastrectomy for gastric cancer, including 19 incisional infections and 31 organ lacuna infections. The corresponding incidence was 12. 2% , 4. 6% and 7.6% , respectively. By univariate analysis, age 〉 75 （χ^2= 5.315, P = 0. 021 ）, preoperative anemia （χ^2 = 3. 983, P = 0. 046 ）, NRS 2002 ≥ 3 （χ^2 = 4. 785, P = 0. 029 ）, diabetes （χ^2= 5. 895, P = 0. 015 ）, preoperative obstruction （χ^2= 5. 250,P = 0. 022） ,undifferentiated carcinoma （χ^2 = 4. 448, P=0. 035 ）, cardiac carcinoma （χ^2 = 5. 265, P = 0. 022） and combined organs resection （χ^2= 4. 165, P = 0. 041 ） were associated with SSI. Multivariate analysis showed that advanced age （ OR = 2. 422, P = 0. 016 ）, diabetes （ OR = 2. 524, P = 0. 026 ）, preoperative obstruction （OR = 2. 098, P = 0. 047 ） and high NRS 2002 score （OR = 1. 969, P = 0. 043 ） were independent risk factors for SSI. Conclusion The independent risk factors of SSI for elderly gastric cancer patients are advanced age, diabetes, preoperative obstruction and high NRS 2002 score.

关 键 词：胃肿瘤 外科伤口感染 老年人 危险因素 

分 类 号：R735.2[医药卫生—肿瘤]