消化道肿瘤术后感染的危险因素及抗感染治疗方案探讨  

Risk factors of postoperative infection in patients with gastrointestinal tumors and anti-infection treatment

作　　者：郭仲卿 张育荣 李凤仙 GUO Zhong-qing;ZHANG Yu-ron;LI Feng-xian(Department of Pharmacy,Beijing Sanhuan Cancer Hospital,Beijing 100122,China)

机构地区：[1]北京市朝阳区三环肿瘤医院药剂科,北京100122

出　　处：《临床医药文献电子杂志》2018年第43期4-7,9,共5页Electronic Journal of Clinical Medical Literature

摘　　要：目的探讨消化道肿瘤术后感染的相关因素,总结术后感染的抗感染治疗方案及转归,为今后预防治疗术后感染提供参考。方法选取我院腹外科2017年1月~2018年1月行胃、结直肠癌手术798例患者病厉。结果有57例患者术后发生了感染,感染率7.14%,年龄≥60、BMI≥25、有糖尿病史、手术时长≥3 h、术中出血量≥500 m L、术前白蛋白水平<30 g/L均为发生术后感染的相关危险因素;差异有统计学意义(P<0.05)。头孢曲松钠、哌拉西林舒巴坦钠、头孢哌酮舒巴坦钠、亚胺培南西司他丁、左奥硝唑等抗感染药物均可显著性治愈术后感染患者。结论术前及术中应有足够的预防术后感染的措施,如使患者机体在术前达到较好的水平、改善手术室人员管理、增加科室间配合、减少手术时间;另外,抗感染治疗的方案的合理性有待进一步完善。Objective To investigate the related factors of postoperative infection in patients with gastrointestinal tumors,summarize the anti-infection treatment and its therapeutic effect,and provide prevention and interventions for infection in the future.Methods 798 cases of postoperative infection from January 2017 to January 2018 in our hospital were retrospectively analyzed.Results Totaled wound infection rate was 7.14%, Multivariate logistic analysis showed that the patient’s age≥60 years old, BMI≥25, diabetes history,the operation time≥3 h, the intraoperative blood loss≥500 ml, and the preoperative albumin level 〈30 g/L were the independent risk factors of postoperative infection in patients with gastrointestinal tumors （P〈0.05）. The anti-infective agents like Sodium ceftriaxone, Piperacillin sulbactam sodium, Cefoperazone sulbactam sodium, Imipenem and cilastatin sodium, and Levornidazole can signifcantly cure the patients of postoperative infection.Conclusion Increasing the preoperative body and psychological preparation of patients, improving the management of the operating room staff, increasing coordination between departments, and reducing the surgical time can reduce the incidence of postoperative infection. The rationality of the anti-infection treatment needs to be improved.

关 键 词：消化道肿瘤 危险因素 抗感染 合理用药 

分 类 号：R969[医药卫生—药理学]