结直肠癌患者术后切口感染的相关因素分析及护理干预研究  

Related factors for postoperative incision infections in patients with colorectal cancer and nursing interventions

作　　者：吴莺燕[1] 吴婧[1] 江金燕[1] 舒芳芳[1] 李小红[1] WU Ying-yan;WU Jing;JIANG Jin-yan;SHU Fang-fang;LI Xiao-hong(Lishui People＇s Hospital,Lishui,Zhejiang 323000,Chin)

机构地区：[1]丽水市人民医院肛肠外科,浙江丽水323000

出　　处：《中华医院感染学杂志》2018年第13期2005-2008,共4页Chinese Journal of Nosocomiology

基　　金：浙江省中西医结合学会科研基金资助项目(2013LYSX004)

摘　　要：目的探讨结直肠癌患者术后手术部位切口感染的影响因素,提出相应护理措施。方法收集医院2015年1月-2017年1月148例结直肠癌手术患者临床资料,分析患者结直肠癌术后手术部位切口感染相关因素,采集切口感染患者切口分泌物进行病原菌鉴定,提出相应护理干预措施。结果结直肠癌术后手术切口感染14例,感染率9.46%;共检出病原菌14株,其中革兰阴性菌10株(71.43%)、革兰阳性菌为4株(28.57%);手术时间、切口大小、体质量指数、术前低白蛋白、糖尿病、术中输血、手术方式、术后并发症为结直肠癌手术患者术后手术部位切口感染的影响因素,(P<0.05);术前低白蛋白、体质量指数(≥25kg/m^2)、腹腔镜手术、术后并发症及手术时间(>3.5h)是结直肠癌手术患者术后手术部位切口感染的独立影响因素(P<0.05)。结论结直肠癌手术患者术后手术部位切口感染影响因素较多,需加强围手术期护理干预,积极改善患者营养状况,控制合并症,加强术后切口护理,减少并发症,并选择腹腔镜手术,避免切口感染的发生。OBJECTIVE To explore the influencing factors for postoperative surgical incision infections in patients with colorectal cancer and put forward corresponding nursing measures.METHODS The clinical data were collected from 148 patients with colorectal cancer who were treated in the hospital from Jan 2015 to Jan 2017,the related factors for the postoperative surgical incision infection were analyzed,the incision secretions specimens were obtained from the patients with incision infection,the isolated pathogens were identified,and the targeted nursing interventions were put forward.RESULTS Totally 14 colorectal cancer patients had postoperative incision infection,with the infection rate 9.46%.A total of 14 strains of pathogens were isolated,10（71.43%）of which were gramnegative bacteria,and 4（28.57%）were gram-positive bacteria.The influencing factors for the postoperative surgical incision infection in the colorectal cancer patients included operation duration,size of incision,body mass index,low level of preoperative albumin,diabetes mellitus,intraoperative blood transfusion,surgical approach and postoperative complications（P〈0.05）.The low level of preoperative albumin,body mass index no less than 25 kg/m^2,laparoscopic surgery,postoperative complications and operation duration more than 3.5 hours were the independent influencing factors for the postoperative surgical incision infections in the colorectal cancer patients（P〈0.05）.CONCLUSIONThere are a variety of influencing factors for the postoperative incision infections in the patients with colorectal cancer.It is necessary to strengthen the nursing intervention during perioperative period,actively improve the nutrition status,control the complications,intensify the postoperative incision care,reduce the incidence of complications and choose the laparoscopic surgery so as to prevent the incision infections.

关 键 词：结直肠癌 手术 切口感染 相关因素 护理干预 

分 类 号：R735.3[医药卫生—肿瘤]