改良单孔多通道腹腔镜前列腺癌根治术后医院感染的危险因素分析  

Analysis of the risk factors of nosocomial infection after modified single port multi-channel laparoscopic radical prostatectomy

作　　者：郑双峰[1] 张秀华[1] 邵丽[1] ZHENG Shuang-feng;ZHANG Xiu-hua;SHAO Li(Operating Room,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院手术室,乌鲁木齐830054

出　　处：《中国医学前沿杂志（电子版）》2018年第7期84-87,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的分析改良单孔多通道腹腔镜前列腺癌根治术(laparoscopic radical prostatectomy,LRP)后医院感染的危险因素。方法选取2013年1月至2017年6月本院收治的136例前列腺癌患者为研究对象,所有患者均采用改良单孔多通道LRP治疗,将术后发生医院感染的患者纳入感染组,未发生感染的患者纳入未感染组,对两组患者的年龄、病程、基础疾病、术前前列腺特异性抗原(prostate specific antigen,PSA)水平、TNM分期、前列腺体积、反复穿刺情况、穿刺时间距手术间隔、手术方式、手术时间、导尿管留置时间等一般情况进行单因素及多因素分析。结果 136例患者术后共有13例发生医院感染,医院感染发生率为9.6%,其中泌尿系统感染10例,呼吸系统感染2例,切口感染1例。年龄、是否合并糖尿病、前列腺体积、有无反复穿刺、手术时间、导尿管留置时间均为改良单孔多通道LRP术后医院感染的影响因素(P_均<0.05)。年龄>65岁、合并糖尿病、前列腺体积≥45 cm^3、导尿管留置时间≥5天均为改良单孔多通道LRP术后医院感染的独立危险因素(P_均<0.05)。结论前列腺癌患者LRP术后医院感染主要发生于泌尿系统,但导致患者发生医院感染的因素较多,高龄、前列腺肥大、合并糖尿病的易感人群应加强术后感染的预防,同时减少不必要的穿刺检查,及时拔除导尿管,降低术后感染风险。Objective To analyze the risk factors of nosocomial infection after modified single port multi-channel laparoscopic radical prostatectomy（LRP）. Method 136 patients with prostate cancer admitted in our hospital from January 2013 to June 2017 were selected as research subjects. All patients were treated with modified single port multi-channel LRP, and the patients who had postoperative nosocomial infection were included in infection group, while those had not been infected were included in uninfected group. The age, course of disease, basic disease, preoperative prostate specific antigen（PSA） level, TNM staging, prostate volume, repeated puncture, interval time from puncture to surgery, operation mode, operation time and indwelling time of urethral catheters were analyzed by single factor and multi-factor analysis. Result Among the 136 patients, 13 cases had nosocomial infection, and the incidence of nosocomial infection was 9.6%, of which 10 cases were urinary system infection, 2 cases were respiratory system infection and 1 case was incision infection. The age, whether or not combined with diabetes mellitus, prostate volume, whether or not had repeated puncture, operation time, indwelling time of urethral catheter were the influencing factors of nosocomial infection after modified single port multichannel LRP（Pall〈0.05）. Age 65 year old, combined with diabetes mellitus prostate volume ≥ 45 cm^3, indvelling time of urethral catheter ≥ 5 days were the independent risk factors for nosocomial infection after modified single port multi-channel LRP（Pall〈0.05）. Conclusion Nosocomial infection in patients with prostate cancer after LRP occurred mainly in the urinary system. But there are many factors that can result in nosocomial infection, the elderly, prostatic hypertrophy and the susceptible population combined with diabetes mellitus should strengthen the prevention of postoperative infection, reduce unnecessary puncture examination, remove catheters in time to reduce the risk of postoperative

关 键 词：前列腺癌 改良单孔多通道腹腔镜下根治术 医院感染 危险因素 

分 类 号：R737.25[医药卫生—肿瘤]