妇科恶性肿瘤术后感染危险因素分析  

Analysis of risk factors for postoperative infection in gynecological malignant tumors

作　　者：靳楠楠[1] 徐国亭[1] 曹喜华[1] JIN Nannan;XU Guoting;CAO Xihua(The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan,China)

机构地区：[1]南阳医学高等专科学校第一附属医院,河南南阳473000

出　　处：《中国病原生物学杂志》2025年第4期494-498,共5页Journal of Pathogen Biology

摘　　要：目的通过对妇科恶性肿瘤术后感染的相关危险因素进行系统分析,旨在为临床预防和治疗提供理论依据。方法采用回顾性调查方法,收集2021-2023年期间93例于本院接受妇科恶性肿瘤手术并发术后感染患者的临床资料,对可能影响术后感染的相关因素进行统计学分析。采集患者分泌物标本,统计分析患者感染部位及病原菌类型。采集患者静脉血,测定血清降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平。结果在93例术后感染患者中,泌尿系统感染占40.86%,手术切口感染占26.88%,呼吸系统感染占11.83%,阴道残端感染占7.53%,盆腔积液感染占5.38%,胃肠道感染占3.23%,盆腔囊肿感染占2.15%,血液系统感染占2.15%。在93例术后感染患者中,共检出102株病原菌。其中,革兰阴性菌70株,包括大肠埃希菌26株,铜绿假单胞菌19株,肺炎克雷伯菌10株,鲍曼不动杆菌7株,阴沟肠杆菌5株,产气肠杆菌2株,产酸克雷伯菌1株。革兰阳性菌27株,包括金黄色葡萄球菌10株,表皮葡萄球菌7株,屎肠球菌5株,粪肠球菌3株,溶血葡萄球菌2株。真菌5株,包括白色假丝酵母菌3株,近平滑假丝酵母菌2株。感染组患者血清CRP水平为(39.95±9.55)mg/L,PCT水平为(4.89±0.92)μg/L,IL-6水平为(105.30±21.42)ng/L。对照组患者血清CRP水平为(5.57±1.82)mg/L,PCT水平为(0.87±0.37)μg/L,IL-6水平为(52.53±13.93)ng/L。感染组患者血清CRP、PCT、IL-6水平显著高于对照组(P<0.05)。单因素分析显示,手术方式、合并糖尿病、合并贫血、手术时间、留置导尿管时间、尿管插管次数、住院时间、膀胱冲洗差异有统计学意义(P<0.05),年龄、术前化学治疗、术中失血量差异无统计学意义(P0.05)。多因素分析显示,手术方式为开腹、合并糖尿病、合并贫血、手术时间≥4h、留置尿管时间≥10d、尿管插管次数≥2次、住院时间≥21d、膀胱冲洗是妇科恶性肿瘤术后合并感染的独Objective By systematic analysis of the relevant risk factors for postoperative infection in gynecological malignant tumors,the aim was to provide a theoretical basis for clinical prevention and treatment.Methods A retrospective investigation method was adopted.The clinical data of 93 patients who underwent gynecological malignant tumor surgery and had postoperative infections in our hospital from January 2021 to December 2023 were collected.Statistical analysis was conducted on the relevant factors that may affect postoperative infections.Secretion specimens from patients were collected to statistically analyze the infection sites and pathogen types of patients.Venous blood from patients was collected to determine the levels of serum procalcitonin(PCT),C-reactive protein(CRP),and interleukin-6(IL-6).Results Among the 93 patients with postoperative infections,urinary system infections accounted for 40.86%,surgical incision infections accounted for 26.88%,respiratory system infections accounted for 11.83%,vaginal stump infections accounted for 7.53%,pelvic effusion infections accounted for 5.38%,gastrointestinal tract infections accounted for 3.23%,pelvic cyst infections accounted for 2.15%,and blood system infections accounted for 2.15%.Among the 93 postoperative infected patients,a total of 102 pathogenic bacteria were detected.Among them,there were 70 stains of Gram-negative bacteria,including 26 stains of Escherichia coli,19 stains of Pseudomonas aeruginosa,10 stains of Klebsiella pneumoniae,7 stains of Acinetobacter baumannii,5 stains of Enterobacter cloacae,2 stains of Enterobacter aerogenes,and 1 stains of Klebsiella orytoca.There were 27 stains of Gram-positive bacteria,including 10 stains of Staphylococcus aureus,7 stains of Staphylococcus epidermidis,5 stains of Enterococcus faecium,3 stains of Enterococcus faecalis,and 2 stains of Staphylococcus haemolyticus.There were 5 stains of fungi,including 3 stains of Candida albicans and 2 stains of Candida parapsilosis.The serum CRP level of patients in the inf

关 键 词：妇科恶性肿瘤 术后感染 危险因素 

分 类 号：R73[医药卫生—肿瘤]