食管癌根治术患者手术切口感染影响因素分析  

Influencing factors of surgical site infection in patients undergoing radical resection of esophageal cancer

作　　者：曾萍[1] 李妍[1] 张洁[1] 赵佳[2] 郭领[2] 李伟伟[3] ZENG Ping;LI Yan;ZHANG Jie;ZHAO Jia;GUO Ling;LI Weiwei(Department of Infection Management,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China;Department of Cardiothoracic Surgery,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China;Department of Oncology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院感染管理科,河南卫辉453100 [2]新乡医学院第一附属医院胸心外科,河南卫辉453100 [3]新乡医学院第一附属医院肿瘤科,河南卫辉453100

出　　处：《新乡医学院学报》2020年第3期239-242,共4页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关项目(编号:201702123)。

摘　　要：目的分析食管癌根治术患者手术切口感染(SSI)发生率及其影响因素,并探讨术前血清白蛋白(Alb)水平在手术切口发生感染中的预测效果。方法回顾性分析385例于2016年1月至2018年1月在新乡医学院第一附属医院行食管癌根治术患者的临床资料,采用logistic回归分析术后发生SSI的危险因素,采用受试者操作特征曲线判断术前血清Alb水平对食管癌术后SSI的预测价值。结果食管癌根治术后患者SSI发生率为13.77%(53/385),其中轻度、中度和重度感染分别为31、14、8例。单因素分析结果显示,患者的性别、年龄、体质量指数(BMI)、吸烟史、糖尿病、手术持续时间、术后住院时间及术前血清Alb水平与SSI有关(P<0.05);患者的饮酒史与SSI无关(P>0.05)。Logistic回归分析显示,患者的年龄、BMI、糖尿病和术前血清Alb水平是SSI的独立危险因素(P<0.05)。轻度、中度、重度SSI患者术前血清Alb水平分别为(48.42±1.50)、(43.34±1.36)、(32.90±1.03)g·L-1,不同程度感染患者术前血清Alb水平两两比较差异均有统计学意义(P<0.05)。术前血清Alb水平预测食管癌术后SSI发生的曲线下面积为0.818(95%可信区间:0.774~0.862,P<0.05),敏感度为98.1%,特异度为62.7%。结论年龄、BMI、糖尿病和术前血清Alb水平是食管癌患者术后发生SSI的危险因素,术前血清Alb水平对预测SSI有一定价值。Objective To analyze the influencing factors of surgical site infection(SSI)in patients who undergoing radical resection of esophageal cancer and explore the value of serum albumin(Alb)level in predicting the prognosis of SSI.Methods The clinical data of 385 patients who underwent radical resection of esophageal cancer in the First Affiliated Hospital of Xinxiang Medical University from January 2016 to January 2018 were analyzed retrospectively.The risk factors of SSI were analyzed by logistic regression analysis;the value of serum Alb level in predicting the occur of SSI was determined by receiver operating characteristic curve.Results The incidence of SSI in patients underwent radical resection of esophageal cancer was 13.77%(53/385).Among the 53 SSI patients,31,14,8 patients were mild,moderate and severe SSI respectively.The results of univariate analysis showed that the sex,age,body mass index(BMI),smoking history,diabetes mellitus,operation time,postoperative hospitalization time and serum Alb level were related to SSI(P<0.05);while the drinking history was not related to SSI(P<0.05).Logistic regression analysis showed that the age,BMI,diabetes mellitus and serum Alb level were independent risk factors for SSI(P<0.05).The serum Alb level in patients with mild,moderate and severe SSI was(48.42±1.50),(43.34±1.36)and(32.90±1.03)g·L-1,respectively.There was significant difference in the serum Alb level among the mild,moderate and severe SSI patients(P<0.05).The area under curve of serum Alb level in predicting the occur of SSI was 0.818(95%confidence interval:0.774-0.862,P<0.05),and the sensitivity was 98.1%,the specificity was 62.7%.Conclusion The age,BMI,diabetes mellitus and serum Alb level are the risk factors for postoperative SSI in patients with esophageal cancer.The preoperative serum Alb level is valuable for predicting SSI.

关 键 词：食管癌根治术 手术切口感染 影响因素 白蛋白 

分 类 号：R735.1[医药卫生—肿瘤]