结直肠癌患者术后腹腔感染病原菌及其危险因素  

Pathogenic bacteria and risk factors of postoperative abdominal infection in patients with colorectal cancer

作　　者：梁海峰 刘新艳 梁译心 李安云 石召强 LIANG Hai-feng;LIU Xin-yan;LIANG Yi-xin;LI An-yun;SHI Zhao-qiang(Dongying District People's Hospital,Dongying,Shandong 257000,China)

机构地区：[1]东营市东营区人民医院肛肠科,山东东营257000 [2]山东省齐鲁师范学院,山东济南250000 [3]东营鸿港医院普外科,山东东营257000

出　　处：《中华医院感染学杂志》2023年第20期3099-3103,共5页Chinese Journal of Nosocomiology

基　　金：山东省科研基金资助项目(2021LK02101)。

摘　　要：目的探讨结直肠癌患者术后腹腔感染病原菌和危险因素及其HIPPO通路基因。方法回顾性分析2019年5月-2022年11月东营市东营区人民医院收治的198例结直肠癌术后患者的临床资料,根据腹腔感染情况分为感染组34例和未感染组164例;统计腹腔感染病原菌,比较两组HIPPO通路基因及临床资料,并予以多因素Logistic回归分析法分析结直肠癌患者术后腹腔感染的危险因素。结果34例感染患者共培养分离病原菌37株,其中革兰阴性菌28株占75.68%,革兰阳性菌8株占21.62%,真菌1株占2.70%,以大肠埃希菌为主;多因素Logistic回归分析结果显示,合并糖尿病、引流管留置时间、术前肠梗阻是结直肠癌患者术后腹腔感染的危险因素(OR=1.726、1.960、2.683,P<0.05);感染组Yes相关蛋白(Yap)、PDZ结合基序转录共激活因子(TAZ)、哺乳动物不育系20样激酶1(mst1)信使核糖核酸(mRNA)水平均高于未感染组(P<0.05)。结论结直肠癌根治术后腹腔感染的风险较高,HIPPO通路可能与腹腔感染的发生有关,而合并糖尿病、引流管留置时间、术前肠梗阻是结直肠癌患者术后腹腔感染的危险因素,且病原菌以革兰阴性菌为主,临床可据此给予针对性的预防及抗菌治疗。OBJECTIVE To investigate the pathogenic bacteria and risk factors of postoperative abdominal infection in colorectal cancer patients and their HIPPO pathway genes.METHODS The clinical data of 198 postoperative colorectal cancer patients admitted to the Dongying District People′s Hospital of Dongying City from May 2019 to Nov.2022 were retrospectively analyzed,and the patients were divided into 34 cases of infected group and 164 cases of uninfected group according to whether they had intraperitoneal infection.The pathogenic bacteria of abdominal infection were counted,the HIPPO pathway genes and clinical data were compared between the two groups,and the risk factors of postoperative abdominal infection in patients with colorectal cancer were analyzed by multivariate logistic regression analysis.RESULTS A total of 37 strains of pathogenic bacteria were cultured and isolated from 34 infected patients,of which 28 strains of gram-negative bacteria accounted for 75.68%,8 strains of gram-positive bacteria accounted for 21.62%,and 1 strain of fungi accounted for 2.70%,mainly Escherichia coli.Multivariate logistic regression analysis showed that the combination of diabetes mellitus,the time of drainage tube retention,and preoperative intestinal obstruction were the risk factors for postoperative abdominal infection in patients with colorectal cancer(OR=1.726,1.960,2.683,P<0.05).The levels of Yes-associated protein(Yap),transcriptional co-activator with PDZ-binding motif(TAZ)and mammalian sterile 20-like kinase 1(mst1)messenger ribonucleic acid(mRNA)in the infected group were higher than those in the uninfected group(P<0.05).CONCLUSION The risk of abdominal infection after radical resection of colorectal cancer was high,and the HIPPO pathway might be related to the occurrence of abdominal infection,while the combination of diabetes mellitus,the time of drainage tube retention,and preoperative intestinal obstruction were the risk factors for postoperative abdominal infection in patients with colorectal cancer,and the path

关 键 词：结直肠癌 术后感染 腹腔感染 HIPPO通路基因 病原菌 危险因素 

分 类 号：R619.3[医药卫生—外科学]