结直肠癌术后切口感染的影响因素  

Influencing factors for postoperative incision infection in colorectal cancer patients undergoing laparoscopic surgery

作　　者：王树江[1] 张明[1] 刘鹏 李宁[2] 邹富胜[2] WANG Shu-jiang;ZHANG Ming;LIU Peng;LI Ning;ZOU Fu-sheng(Tianjin Occupational Disease Prevention and Treatment Institute{Tianjin Workers Hospital),Tianjin 300011≫China;不详)

机构地区：[1]天津市职业病防治院(天津市工人医院)普外科,天津300011 [2]天津市南开医院普外科,天津300100

出　　处：《中华医院感染学杂志》2019年第21期3270-3274,共5页Chinese Journal of Nosocomiology

基　　金：国家自然基金青年基金资助项目(81703094)

摘　　要：目的探讨经脐微创腹腔镜与传统腹腔镜结直肠癌根治术术后切口感染的影响因素及对炎性因子的影响。方法对天津市职业病防治院收治的74例结直肠癌患者进行分组研究,对照组使用传统腹腔镜结直肠癌根治术,研究组经脐微创腹腔镜完成结直肠癌根治术。分析患者术后切口感染发生情况及影响因素,比较两组患者炎性因子水平、术中术后指标。结果术后切口感染发生率为22.97%(17/74)。手术时间、体质量指数、围手术期伴有低体温、术中输血、手术方式为传统腹腔镜、手术部位、术前伴有低白蛋白血症、糖尿病是患者感染的影响因素。术前,两组患者炎症因子比较,研究组低于对照组(P<0.05)。手术时间比较无统计学差异,研究组术中出血量、肠道功能恢复时间、下床活动时间、术后住院时间少于对照组(P<0.05)。结论手术时间、BMI、围手术期体温、术中输血、手术方式、手术部位、术前伴有低白蛋白血症、糖尿病是影响结直肠癌术后切口感染的影响因素,相对于传统腹腔镜结直肠癌根治术,经脐微创腹腔镜结直肠癌根治术的术中出血量、肠道功能恢复时间、下床活动时间、术后住院时间较少,能促使患者术后尽快恢复。OBJECTIVE To explore the influencing factors for postoperative incision infection in the colorectal cancer patients undergoing transumbilical minimally invasive laparoscopic surgery and conventional laparoscopic radical resection and observe the influence on inflammatory factors.METHODS A total of 74 patients with colorectal cancer who were treated in Tianjin Occupational Disease Prevention and Treatment Institute were enrolled in the study,the control group was treated with conventional laparoscopic radical resection,and the study group was treated with transumbilical minimally invasive laparoscopic surgery for radical resection.The incidence of postoperative incision infection and the influencing factors were observed,and the levels of inflammatory factors,intraoperative and postoperative indexes were compared between the two groups of patients.RESULTS The incidence rate of postoperative incision infection was 22.97%(17/74).The influencing factors for the infection included operation duration,body mass index,perioperative hypothermia,intraoperative blood transfusion,conventional laparoscope,surgical sites,preoperative hypoalbuminemia and diabetes mellitus.The levels of inflammatory factors of the study group were significantly lower than those of the control group before the surgery(P<0.05).There was no significant difference in the operation duration.The intraoperative blood loss volume of the study group was significantly less than that of the control group;the time of recovery of intestinal function,time of off-bed activity and length of postoperative hospital stay were significantly shorter in the study group than in the control group(P<0.05).CONCLUSION The operation duration,BMI,perioperative body temperature,intraoperative blood transfusion,surgery mode,surgical site,preoperative hypoalbuminemia and diabetes mellitus are the influencing factors for the postoperative incision infection in the colorectal cancer patients.The intraoperative blood loss volume,time of recovery of intestinal function,time of off

关 键 词：经脐微创腹腔镜 传统腹腔镜 结直肠癌根治术 切口感染 炎性因子 

分 类 号：R735.3[医药卫生—肿瘤]