胆管结石再次手术术后感染的危险因素分析  

The unalysis of risk factors of infection afier reoperation of bile duct stones

作　　者：蒋金玲 张小小[1] 金赟[1] 于源泉[1] 周冬儿[1] 刘达人[1] 李江涛[1] Jiang Jinling

机构地区：[1]浙江大学医学院附属第二医院,310009 [2]浙江省仙居县中医院,317300

出　　处：《浙江临床医学》2021年第6期792-794,797,共4页Zhejiang Clinical Medical Journal

摘　　要：目的分析胆管结石再次手术术后感染的危险因素。方法回顾性收集本院胆管结石再次手术患者126例,另同期随机选取胆管结石首次手术患者126例作为对照,比较两组的一般情况、个人史、术前检查、手术情况等临床资料。再次手术组根据是否发生术后感染分为感染组(31例)和非感染组(95例),对可能与术后感染发生相关的因素进行单因素分析及Logistic回归多因素分析结果126例胆管结石再次手术共发生术后感染31例(24.6%),远高于胆管结石首次手术组的术后感染率8.7%。单因素Logistic回归分析显示,年龄(≥60岁)、手术时间(≥237.5 min)、术中出血量(≥125 ml)、输血、术后腹腔引流量(≥542.5 ml)、术后住院时间(≥11.5 d)、NNIS分级2级与胆管结石再次手术术后感染的发生相关(P<0.05)。多因素Logistic回归分析显示,术后腹腔引流量(≥542.5 ml)、年龄(≥60岁)和术中胆汁培养阳性为胆管结石再次手术术后感染发生的独立危险因素结论胆管结石再次手术术后感染应引起临床医生的重视,并通过预防以减低发生率。Objective Analysis of risk factors for infection after reoperation of bile duct stones.Methods A retrospective collection of 126 patients with bile duct stones undergoing reoperation in our hospital was collected.In the same period,126 patients with bile duct stones undergoing surgery for the first time were randomly selected as controls to compare the general conditions,personal history,preoperarive examination,and surgical status of the two groups.The reoperation group was divided into infection group(31 cases)and non—infection group(95 cases)according to whether postoperative infection occurred.Univariate analysis and logistic regression multivariate analysis were performed on factors that may be related to the occurrence of postoperative infection.Results In 126 cases of bile duct stones reoperation,31 cases(24.6%)had postoperative infection,which was much higher than the postoperative infection rate of 8.7%in the first operation group of bile duct stones.Univariate logistic regression analysis showed that age(≥60 years),operation time(≥237.5 min),intraoperative blood loss(≥125 ml),blood transfusion,postoperative abdominal drainage(≥542.5 ml),postoperative hospital stay(≥11.5 d),NNIS grade 2 was related to the occurrence of infection after reoperation of bile duct stones(P<0.05).Multivariate logistic regression analysis showed that postoperative abdominal drainage(≥542.5 nil),age(≥60 years)and positive bile culture during operation were independent risk factors for infection of bile duct stones after reoperation.Conclusion Infection after reoperation of bile duct stones should arouse the attention of clinicians,and prevent them to reduce the incidence.

关 键 词：胆管结石再次手术 术后感染 危险因素 预防措施 

分 类 号：R65[医药卫生—外科学]