老年前列腺癌患者腹腔镜根治术后医院感染的相关因素  

Related factors for postoperative nosocomial infection in elderly prostate cancer patients undergoing laparoscopic radical surgery

作　　者：周演铃[1] 马庆华 陶伟 薛波新 张丽 ZHOU Yan-ling;MA Qing-hua;TAO Wei;XUE Bo-xin;ZHANG Li(Second Affiliated Hospital of Suzhou University,Suzhou,Jiangsu 215004,China;不详)

机构地区：[1]苏州大学附属第二医院手术室,江苏苏州215004 [2]苏州市相城区第三人民医院预防保健科,江苏苏州215131 [3]苏州高新区人民医院泌尿外科,江苏苏州215010

出　　处：《中华医院感染学杂志》2020年第16期2490-2493,共4页Chinese Journal of Nosocomiology

基　　金：江苏省高校科研预研基金资助项目(SDFEYQN1818)。

摘　　要：目的分析老年前列腺癌患者腹腔镜根治术后医院感染的相关因素,为医院感染的预防工作提供依据。方法选取2016年1月-2019年6月苏州大学附属第二医院收治的309例经腹腔镜行前列腺癌根治术的老年患者为研究对象,对其术后医院感染情况进行回顾性分析,通过查阅病历方式收集其发生感染患者和未发生感染患者的临床特征数据,分析术后医院感染的相关因素。结果有30例发生术后感染,感染率为9.71%,其中,泌尿系统感染20例、呼吸系统感染8例,手术部位感染2例,分别占66.67%、26.67%、6.67%。感染组患者中年龄>70岁、合并糖尿病、前列腺体积≥45 cm^3、术前反复穿刺、手术时间≥120 min、术后留置导尿管时间≥5 d的患者比例高于非感染组,差异均有统计学意义(P<0.05)。Logistic多元回归分析结果显示,年龄、合并糖尿病、手术时间、术后留置导尿管时间与老年前列腺癌腹腔镜根治术后医院感染的发生具有相关性(P<0.05)。结论泌尿系统感染是老年前列腺癌腹腔镜根治术后医院感染的主要类型,其发生风险与多种因素有关,临床医护人员应采用针对性的干预措施,达到降低感染发生率的目的。OBJECTIVE To investigate the related factors for postoperative nosocomial infection in the elderly prostate cancer patients undergoing laparoscopic radical surgery so as to provide basis for prevention of nosocomial infection. METHODS A total of 309 elderly patients with prostate cancer who underwent laparoscopic radical surgery in the Second Affiliated Hospital of Suzhou University from Jan 2016 to Jun 2019 were enrolled in the study, the incidence of postoperative nosocomial infection was retrospectively analyzed, the clinical data were collected from the patients with infection and the patients without infection by review of medical records, and the related factors for the postoperative nosocomial infection were analyzed. RESULTS Totally 30 patients had postoperative infection, with the infection rate 9.71%, 20(66.67%) of whom had urinary system infection,(26.67%) had respiratory system infection, and 2(6.67%) had surgical site infection. The proportions of the patients with more than 70 years of age, diabetes mellitus, volume of prostate no less than 45 cm^3, repeated puncture before surgery, operation duration no less than 120 min and postoperative catheter indwelling time no less than 5 days were significantly higher in the infection group than in the non-infection group(P<0.05). Multivariate logistic regression analysis showed that the incidence of postoperative nosocomial infection in the elderly prostate cancer patients undergoing laparoscopic radical surgery was associated with the age, complication with diabetes mellitus, operation duration and postoperative catheter indwelling time(P<0.05). CONCLUSION The patients with urinary system infection are dominant among the elderly prostate cancer patients who have nosocomial infection after the laparoscopic radical surgery. It is necessary for the clinical staff to take targeted intervention measures so as to reduce the incidence of infection.

关 键 词：老年 腹腔镜 前列腺癌根治术 术后感染 相关因素 

分 类 号：R737.25[医药卫生—肿瘤]