结直肠癌术后腹腔感染病原菌分布特点及优质护理效果分析  

Distribution characteristics of pathogenic bacteria in postoperative abdominal infections of colorectal cancer and analysis of high-quality nursing effects

作　　者：薛丽 王灿 梁晓静 秦乐 尹青青 张梦玉 王贵芳 XUE Li;WANG Can;LIANG Xiaojing;QIN Yue;YIN Qingqing;ZHANG Mengyu;WANG Guifang(The Affiliated Hospital of Hebei University of Traditional Chinese Medicine,Shijiazhuang 050000,China)

机构地区：[1]河北中医药大学附属医院(河北中医院),河北石家庄050000

出　　处：《中国病原生物学杂志》2024年第3期351-354,共4页Journal of Pathogen Biology

基　　金：河北省中医药管理局科研计划项目(No.2020103)。

摘　　要：目的探析结直肠癌术后腹腔感染患者病原菌分布特点及优质护理效果。方法选取2012-2022年本院收治的262例结直肠癌患者为研究对象,根据腹腔感染情况,分为感染组与未感染组,对比两组患者临床资料分析腹腔感染患者临床特征。腹腔感染者采集术后引流液或腹腔穿刺液,进行病原菌鉴定及药敏试验。将腹腔感染患者随机分为两组,对照组采用常规护理方案,实验组采用优质护理方案,对比两组患者护理临床疗效及满意度。结果感染组与未感染组患者合并糖尿病、肿瘤分期、术前肠梗阻、术中出血量、术后发生吻合口瘘对比差异均有统计学意义(P<0.05),性别、年龄、肿瘤位置、合并高血压、分化程度、术后造瘘对比差异均无统计学意义(P>0.05)。共检出病原菌33株,其中革兰阴性菌占75.76%,主要为大肠埃希菌、肺炎克雷伯菌。革兰阳性菌占21.21%,主要为粪肠球菌。真菌占3.03%,为白色假丝酵母菌。大肠埃希菌对氨苄西林、头孢唑林、环丙沙星、左氧氟沙星的耐药率高于50%,对头孢吡肟、亚胺培南、美罗培南、妥布霉素、阿米卡星的耐药率低于30%。肺炎克雷伯菌对氨苄西林、头孢唑林、头孢曲松、环丙沙星的耐药率高于50%,对头孢吡肟、亚胺培南、美罗培南、妥布霉素、阿米卡星的耐药率低于30%。经护理干预后,实验组患者总有效率为91.67%,对照组患者总有效率为54.55%,两组患者的总有效率差异有统计学意义(P<0.05)。实验组患者总满意度为100%,对照组患者总满意度为63.64%,两组患者对护理的满意度差异有统计学意义(P<0.05)。结论结直肠癌术后腹腔感染可能与糖尿病、肿瘤分期、术前肠梗阻、术中出血量、术后发生吻合口瘘有关,病原菌主要为革兰阴性菌。大肠埃希菌、肺炎克雷伯菌对临床常见抗菌药物的耐药率较高。对腹腔感染患者实施优质护理,可有效提升患�Objective To explore the distribution characteristics of pathogens in patients with postoperative abdominal infections of colorectal cancer and the effectiveness of high-quality nursing care.Methods 262 colorectal cancer patients admitted to our hospital from 2012 to 2022 were selected as the study subjects.According to whether abdominal infection occurred,patients were divided into an infected group and an uninfected group.Clinical data of patients with abdominal infection were compared between the two groups to analyze their clinical characteristics.The postoperative drainage fluid or abdominal puncture fluid were collected from patients with abdominal infection for pathogen identification and drug sensitivity testing.The patients were randomly divided with abdominal infection into two groups.The control group received routine nursing care,while the experimental group received high-quality nursing care.The clinical efficacy and satisfaction of nursing care were compared between the two groups of patients.Results There were statistically significant differences between the infected group and the uninfected group in patients with diabetes,tumor stage,preoperative intestinal obstruction,intraoperative bleeding,and postoperative anastomotic fistula(P<0.05),while there were no statistically significant differences in gender,age,tumor location,combined hypertension,differentiation,and postoperative fistula(P>0.05).A total of 33 strains of pathogenic bacteria were detected,of which Gram negative bacteria accounted for 75.76%,mainly Escherichia coli and Klebsiella pneumoniae.Gram positive bacteria accounted for 21.21%,mainly Enterococcus faecalis.Fungi accounted for 3.03%,which were Candida albicans.The resistance rate of E.coli to ampicillin,ceftriaxone,ciprofloxacin,and levofloxacin was over 50%,while the resistance rate to cefepime,imipenem,meropenem,tobramycin,and amikacin was less than 30%.The resistance rate of K.pneumoniae to ampicillin,ceftriaxone,ceftriaxone,and ciprofloxacin was over 50%,while the resistance

关 键 词：结直肠癌 腹腔感染 病原菌 优质护理 

分 类 号：R473.73[医药卫生—护理学]