结直肠肿瘤患者手术部位感染相关因素及病原学分析  

Related factors and etiological characteristics for surgical site infections in patients with colorectal cancer

作　　者：徐朋[1] 赵丽香[1] 唐琳娜 王洋[1] 吕玉玲[1] 赵方[1] 王丽丽[1] XU Peng;ZHAO Li-xiang;TANG Lin-na;WANG Yang;LYU Yu-ling;ZHAO Fang;WANG Li-li(Qian f oshan Hospital of Shandong Province,J inan,Shandong 250014,China)

机构地区：[1]山东省千佛山医院感染管理科,山东济南250014

出　　处：《中华医院感染学杂志》2018年第18期2803-2806,共4页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展计划基金资助项目(2011HZ082)

摘　　要：目的探讨结直肠肿瘤手术后手术部位感染(SSI)的相关因素及病原学特点。方法选择2016年1月-2017年6月在医院行结直肠肿瘤切除术患者379例进行目标性监测,收集患者的临床资料,采用单因素和多因素Logistic回归分析患者手术部位感染的相关因素及感染病原学的分布特点。结果 379例结直肠肿瘤切除患者,手术部位感染38例,感染率10.03%;单因素分析结果显示合并糖尿病、急诊手术、手术持续时间>180min、BMI、ASA评分、肿瘤部位、术后抗菌药物使用时间、术后肠瘘是结直肠肿瘤患者手术部位感染的相关因素,多因素Logistic回归分析结果显示:糖尿病、BMI、肿瘤部位、手术时间、术后肠瘘是结直肠肿瘤切除术发生SSI的独立相关因素;38例手术部位感染患者,共分离病原菌48株,其中革兰阴性菌38株,革兰阳性菌10株,构成比分别为79.17%和20.83%。结论结直肠肿瘤切除术后手术部位感染率较高,相关因素多,病原菌以革兰阴性菌为主,临床应明确风险,早期采取有效措施,防治手术部位感染,以提高手术疗效。OBJECTIVE To explore the related factors and etiological characteristics of postoperative surgical site infections（SSI）in patients with colorectal cancer.METHODS A targeted surveillance was carried out for 379 patients with colorectal cancer who underwent resection in the hospital from Jan 2016 to Jun 2017,the clinical data were collected from the patients,and the univariate analysis and multivariate logistic regression analysis were performed for the related factors for the SSI and etiological characteristics of the infections.RESULTS Of the 379 patients with colorectal cancer,38 had SSI,with the infection rate 10.03%.The result of the univariate analysis showed that the related factors for the SSI in the patients with colorectal cancer included complication with diabetes mellitus,emergency surgery,operation duration more than 180 min,BMI,ASA scores,tumor sites,times of use of antibiotics after surgery and postoperative intestinal fistula.The result of the multivariate logistic regression analysis indicated that diabetes mellitus,BMI,tumor sites,operation duration and postoperative intestinal fistula were the independent related factors for the SSI in the patients with colorectal cancer.A total of 48 strains of pathogens were isolated from 38 patients with SSI,38（79.17%）of which were gram-negative bacteria,and 10（20.83%）were gram-positive bacteria.CONCLUSION The incidence rate of SSI is high among the patients with colorectal cancer after the resection,there are a variety of related factors for the infections,the gram-negative bacteria are dominant among the pathogens.It is necessary for the hospital to identify the risk factors and take effective measures in early stage so as to prevent the SSI and improve the efficacy of surgery.

关 键 词：结直肠肿瘤 手术部位感染 危险因素 病原菌 

分 类 号：R619[医药卫生—外科学]