胃肠道手术患者术后感染病原菌及感染危险因素分析  

The pathogenic bacteria and risk factors of postoperative infection in patients undergoing gastrointestinal surgery

作　　者：崔颖[1] 陈纬纬 陶庆松[2] 胡宏海 吴梦秋 CUI Ying;CHEN Wei-wei;TAO Qing-song;HU Hong-hai;WU Meng-qiu(Operating Room,Zhongda Hospital,Southeast University,Nanjing,Jiangsu 210009,China;不详)

机构地区：[1]东南大学附属中大医院手术室,江苏南京210009 [2]东南大学附属中大医院普外科 [3]南京医科大学附属儿童医院重点实验室

出　　处：《中国微生态学杂志》2021年第5期556-559,共4页Chinese Journal of Microecology

基　　金：南京市医学科技发展重点项目(ZKX18039)。

摘　　要：目的探究胃肠道手术患者术后感染病原菌及其感染高危因素,为该类患者的治疗提供参考。方法选择2017年1月至2019年10月于我院行胃肠道手术的106例患者为研究对象,检测感染患者病原菌分布,同时检测感染与非感染患者肠道菌群情况,分析患者术后感染的相关危险因素。结果 106例胃肠道手术患者中感染18例(16.98%),共分离出病原菌23株,其中革兰阴性菌占52.17%(12/23),以大肠埃希菌(34.78%,8/23)为主;革兰阳性菌占43.48%(10/23),以金黄色葡萄球菌(26.09%,6/23)为主;真菌占4.35%(1/23)。感染患者肠道大肠埃希菌、肠杆菌数量均明显高于未感染患者,双歧杆菌数量明显低于未感染患者(均P<0.05)。Logistic分析显示,年龄>60岁、急诊手术、普通手术室、参观手术人数>3人、手术时间>2 h、接台手术均为胃肠道手术患者术后感染的独立危险因素(均P<0.05)。结论胃肠道手术患者术后感染风险较高,同时会出现肠道菌群失衡。重视患者高危因素对提高患者手术效果,调整肠道菌群失衡和改善患者预后意义重大。Objective To discuss the pathogenic bacteria and the high risk factors of infection in patients undergoing gastrointestinal surgery and provide a reference for the treatment. Methods A total of 106 patients who accepted gastrointestinal surgery in our hospital from January 2017 to October 2019 were selected. The distribution of pathogenic bacteria, intestinal flora and the risk factors of postoperative infection were analyzed. Results In the 106 patients, 18(16.98%) had postoperative infection and 23 pathogens were isolated, among which Gram-negative bacteria accounted for 52.17%(12/23), with E.coli being predominant(34.78%, 8/23);Gram-positive bacteria accounted for 43.48%(10/23), with Staphylococcus aureus being predominant(26.09%, 6/23);Fungi accounted for(4.35%, 1/23). In the patients with infection, the amounts of intestinal Escherichia coli and Enterobacteria were significantly higher and that of Bifidobacteria was significantly lower than in the patients without infection, respectively(all P<0.05). Logistic analysis showed that age >60 years, emergency operation, general operation room, number of patients visiting operation >3, operating time >2 hours and operation on platform were the independent risk factors of postoperative infection in patients with gastrointestinal operation(all P<0.05). Conclusion The risk of postoperative infection in patients with gastrointestinal operation is high, and the imbalance of intestinal flora will appear. It is of great significance to pay attention to the high risk factors of patients to improve the operation effect, adjust the imbalance of gastrointestinal flora and improve the prognosis of patients.

关 键 词：胃肠道手术 感染 病原菌 肠道菌群 危险因素 

分 类 号：R656[医药卫生—外科学]