结直肠癌患者术后切口感染的病原菌分布特点及影响因素分析

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英文篇名：Distribution Characteristics and Influencing Factors of Pathogenic Bacteria of Incision Infection in Patients with Colorectal Cancer after Operation 作者：王爱华 ; 魏晓军 英文作者：WANG Ai-hua;WEI Xiao-jun;Department of Quality Management Section,the 7th Medical Center of PLA General Hospital;Department of General Surgery,the 7th Medical Center of PLA General Hospital; 关键词：结直肠肿瘤 ; 外科伤口感染 ; 影响因素分析 英文关键词：Colorectal neoplasms;;Surgical wound infection;;Root cause analysis 中文刊名：LCWZ 英文刊名：Clinical Misdiagnosis & Mistherapy 机构：中国人民解放军总医院第七医学中心质量管理科;中国人民解放军总医院第七医学中心普通外科; 出版日期：2019-06-22 出版单位：临床误诊误治 年：2019 期：v.32;No.286 语种：中文; 页：LCWZ201906022 页数：4 CN：06 ISSN：13-1105/R 分类号：94-97

摘要

目的探讨结直肠癌患者术后切口感染的病原菌分布特点及影响因素。方法选取我院2017年1月—2018年10月收治的行手术治疗的结直肠癌264例,按照术后切口感染情况,分为感染组与未感染组。记录所有患者的一般资料,观察感染组病原菌分布特点,分析术后切口感染的影响因素。结果本研究术后切口感染30例,无术后切口感染234例,发生率为11.36%。感染组共检出病原菌44株,其中革兰阴性菌30株(68.18%),革兰阳性菌14株(31.82%)。多因素logistic回归分析显示,年龄≥60岁、体质量指数≥24 kg/m~2、合并糖尿病、临床分期Ⅲ～Ⅳ期、采用开腹手术、手术时间≥3.0 h是结直肠癌患者术后切口感染的独立危险因素(P<0.05)。结论根据结直肠癌患者术后切口感染病原菌分布特点及影响因素,采取针对性、个体化的围术期干预措施可切实降低术后切口感染的发生率,显著改善患者预后。
        Objective To investigate the distribution characteristics and influencing factors of pathogenic bacteria of incision infection in patients with colorectal cancer(CRC) after operation. Methods The clinical data of 264 patients with CRC treated in our hospital from January 2017 to October 2018 were selected and divided into infection group and non-infection group according to the postoperative incision infection. The general data of all patients were recorded.In addition, the distribution characteristics of pathogens were observed, and the influencing factors of postoperative incision infection were further analyzed. Results In this study, 30 patients had incision infection, and 234 had no incision infection. The incision infection rate was 11.36%. A total of 44 pathogenic bacteria were detected in the infection group, including 30(68.18%) Gram-negative bacteria and 14(31.82%) Gram-positive bacteria. Multivariate logistic regression analysis showed that age(≥60 years of age), body mass index(≥24 kg/m~2), diabetes mellitus, clinical stage Ⅲ-Ⅳ, laparotomy and duration of operation(≥3.0 h) were independent risk factors for incision infection in patients with CRC after operation. Conclusion According to distribution characteristics and influencing factors of pathogenic bacteria of incision infections in CRC patients after operation, targeted and individualized perioperative interventions can effectively reduce the incidence of incision infection and significantly improve the prognosis of patients.

引文

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