胃肠道术后患者肠道菌群失衡状况及切口感染危险因素  

Intestinal flora imbalance and risk factors of incision infection in patients after gastrointestinal surgery

作　　者：刘楠[1] 袁海娟[1] 王伟[1] LIU Nan;YUAN Haijuan;WANG Wei(Department of Gastrointestinal Surgery,North Jiangsu People’s Hospital,Yangzhou Jiangsu 225000,China)

机构地区：[1]江苏省苏北人民医院胃肠外科,江苏扬州225000

出　　处：《临床与病理杂志》2022年第11期2745-2750,共6页Journal of Clinical and Pathological Research

摘　　要：目的:分析胃肠道术后患者肠道菌群失衡状况及切口感染的危险因素。方法:回顾性分析江苏省苏北人民医院2020年2月至2022年2月收治的行胃肠道手术的455例患者,将术后切口感染的35例患者作为感染组,无切口感染的420例患者作为无感染组。将术后切口感染患者病原学标本送检,检测其病原菌及两组肠道菌群分布情况,并对胃肠道术后患者切口感染危险因素进行单因素、多因素分析。结果:胃肠道术后患者切口感染发生率为7.69%。感染组患者大肠埃希菌、肠杆菌数量均高于无感染组,双歧杆菌数量低于无感染组(均P<0.05)。感染组年龄≥65岁、急诊手术、手术切口≥10 cm、Ⅲ/Ⅳ级切口、开腹手术、普通手术室、参观手术人数>3、手术时间>2 h、接台手术的术后肠道感染比例均高于无感染组(均P<0.05)。多因素logistic回归分析显示:年龄、手术时机、手术切口长度、手术切口等级、手术方式、手术室类型、参观手术人数、接台手术均是胃肠道术后患者肠道感染的独立危险因素(均P<0.05)。结论:胃肠道术后患者发生感染风险较高,且可出现肠道菌群失衡,病原菌以革兰氏阴性菌为主,危险因素明确,临床应积极采取措施,以改善预后。Objective: To analyze the imbalance of intestinal flora and the risk factors of incision infection in patients after gastrointestinal surgery. Methods: A total of 455 patients who underwent gastrointestinal surgery in North Jiangsu People’s Hospital from February 2020 to February 2022 were retrospectively analyzed. Thirty-five patients with postoperative incision infection were selected as an infection group, and 420 patients without postoperative incision infection were selected as a non-infection group. The etiological specimens of patients with postoperative incision infection were sent for inspection to detect the distribution of pathogenic bacteria and the distribution of intestinal flora in the 2 groups. The risk factors of incision infection in patients a?ter gastrointestinal surgery were analyzed by univariate and multivariate analysis. Results: The incidence of incision infection in patients after gastrointestinal surgery was 7.69%. The number of Escherichia coli and Enterobacter in the infection group was higher than that in the non-infection group, and the number of Bifidobacteria was lower than that in the non-infection group(all P<0.05). In the infection group, the postoperative intestinal infection proportion after the surgery with age ≥65 years old, emergency surgery, surgical incision ≥10 cm, grade Ⅲ/Ⅳ incision, open surgery, general operating room, number of visitors to the operation >3, operation time >2 h, the non-first operation, was higher than that in the non-infection group(all P<0.05). Multivariate logistic regression analysis showed age, operation timing, length of incision, grade of incision, operation method, the type of operating room, the number of visitors to the operation, and the non-first operation were the gastrointestinal independent risk factors for intestinal infection in postoperative patients(all P<0.05). Conclusion: Patients after gastrointestinal surgery have a high risk of infection, and may have an imbalance of intestinal flora. The pathogenic bacteria are main

关 键 词：胃肠道手术 肠道菌群失衡 病原菌 切口感染 危险因素 

分 类 号：R656[医药卫生—外科学]