结肠癌根治术后患者腹腔感染的危险因素分析  

Analysis of risk factors for abdominal infection in patients after radical colon cancer surgery

作　　者：孙振 谢毅[2] 孙亚峰[3] 白军伟[2] SUN Zhen;XIE Yi;SUN Ya-feng;BAI Jun-wei(Department of General Surgery,Shangqiu Central Hospital,Shangqiu 476000,Henan,CHINA;Department of Gastrointestinal Surgery,Henan Provincial People's Hospital,Zhengzhou 450000,Henan,CHINA;Department of Anorectal Disease,Shangqiu First People's Hospital,Shangqiu 476100,Henan,CHINA)

机构地区：[1]商丘市中心医院普外科,河南商丘476000 [2]河南省人民医院胃肠外科,河南郑州450000 [3]商丘市第一人民医院肛肠科,河南商丘476100

出　　处：《海南医学》2023年第12期1774-1777,共4页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20210047)。

摘　　要：目的探究结肠癌根治术后腹腔感染的危险因素,为促进术后恢复、预后改善提供参考。方法回顾性分析2019年10月至2022年4月商丘市中心医院收治的275例结肠癌根治术患者的临床资料,根据术后是否出现腹腔感染分为腹腔感染组34例和未感染组241例,比较两组患者的临床资料,并采用多因素Logistic回归分析术后腹腔感染的相关危险因素。结果两组患者的糖尿病、贫血、预防性抗生素应用情况、术前外周血中性粒细胞/淋巴细胞比值(NLR)、血清癌胚抗原(CEA)水平、手术时间、引流管置管时间、术后发生吻合口瘘比较差异均有统计学意义(P<0.05);经多因素Logistic回归分析结果显示,糖尿病、贫血、术前NLR水平、术前CEA水平、手术时间、引流管置管时间、术后发生吻合口瘘均是结肠癌根治术后发生腹腔感染的危险因素(P<0.05),而预防性抗生素的应用是预防腹腔感染的保护因素(P<0.05)。结论结肠癌患者糖尿病、贫血、预防性抗生素应用情况、术前NLR、CEA水平、手术时间、引流管置管时间、术后发生吻合口瘘等因素影响其根治术后腹腔感染,对预后评估、临床干预具有现实指导意义。Objective To investigate the risk factors of abdominal cavity infection after radical colon cancer surgery,so as to provide reference for promoting postoperative recovery and prognosis improvement.Methods A retrospective analysis was conducted on the clinical data of 275 patients with colorectal cancer who underwent radical surgery at Shangqiu Central Hospital from October 2019 to April 2022.They were divided into an abdominal infection group of 34 patients and an uninfected group of 241 patients based on the occurrence of abdominal infection after surgery.The clinical data of the two groups of patients were compared,and multivariate logistic regression analysis was used to analyze the relevant risk factors of postoperative abdominal infection.Results There were statistically significant differences in diabetes,anaemia,prophylactic antibiotic application,preoperative peripheral blood neutrophil/lymphocyte ratio(NLR),serum carcinoembryonic antigen(CEA)levels,duration of surgery,duration of drain placement,and occurrence of anastomotic fistula between the two groups(P<0.05).Diabetes mellitus,anaemia,preoperative NLR level,preoperative CEA level,duration of surgery,duration of drain placement,and the occurrence of anastomotic fistula after surgery were all risk factors for the development of abdominal infection after radical colon cancer surgery(P<0.05),while the application of prophylactic antibiotics was a protective factor for the development of abdominal infection(P<0.05).Conclusion Diabetes,anemia,prophylactic antibiotic application,preoperative NLR,CEA level,duration of surgery,duration of drain placement,and occurrence of postoperative anastomotic fistula in colon cancer patients affect their post-radical abdominal infection,and have practical guidance for prognostic assessment and clinical intervention.

关 键 词：结肠癌 根治术 腹腔感染 危险因素 

分 类 号：R735.35[医药卫生—肿瘤]