摘要
目的分析结直肠癌手术患者术后切口部位感染病原菌特点及感染因素,为临床预防提供参考依据。方法选取2015年1月-2016年12月医院收治行结直肠癌手术的患者220例,术后记录切口感染情况,对切口部位分泌物进行病原菌培养与鉴定,分析病原菌特点。探讨引发术后切口部位感染的影响因素,并提出临床预防措施。结果患者术后发生切口部位感染50例,感染率为22.7%。50例患者共分离病原菌68株,其中革兰阴性菌40株,占58.8%,革兰阳性菌21株,占30.9%,真菌7株,占10.3%,病原菌中排名前3位依次为大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌,分别占23.5%、17.7%、14.7%。对患者术后切口部位感染相关因素进行多因素Logistic回归分析,结果显示,体质量指数高、合并糖尿病、手术持续时间长以及术后造瘘是引发术后切口感染的影响因素,差异有统计学意义(P<0.05)。结论行结直肠癌手术患者术后切口部位感染发生率较高,病原菌以革兰阴性菌为主,引发患者术后切口感染的影响因素较多,因此临床上应积极控制患者的体质量及血糖,严格按照手术操作程序减少手术持续时间,且对患者生命体征变化进行严密监测,以降低结直肠癌患者术后切口部位感染的发生率。
OBJECTIVE To investigate the characteristics of pathogens causing postoperative surgical site infections in patients with colorectal cancer and analyze the related factors for the infections so as to provide guidance for clinical prevention.METHODS A total of 220 patients with colorectal cancer who were treated in the hospital from Jan 2015 to Dec 2016 were enrolled in the study,the incidence rates of postoperative surgical site infections were recorded,the secretions of incision sites were collected for culture of pathogens,the isolated pathogens were identified,the characteristics of the pathogens were analyzed,the influencing factors for the postoperative incision infections were explored,and the clinical prevention measures were put forward.RESULTS Totally 50 patients had the postoperative incision infections,with the infection rate 22.7%.Totally 68 strains of pathogens were isolated from the 50 patients,40（58.8%）of which were gram-negative bacteria,21（30.9%）were gram-positive bacteria,and 7（10.3%）were fungi.Escherichia coli,Staphylococcus aureus and Pseudomonas aeruginosa ranked the top 3 species of pathogens among the pathogens,accounting for 23.5%,17.7% and 14.7%,respectively.The result of multivariate logistic regression analysis showed that the high body mass indexes,complication with diabetes mellitus,long operation duration and postoperative fistulization were the influencing factors for the postoperative incision infections,and there were significant differences（P〈0.05）.CONCLUSIONThe incidence of postoperative incision infections is high among the patients with colorectal cancer,the gram-negative bacteria are dominant among the pathogens,there were a variety of influencing factors for the postoperative incision infections,therefore,it is necessary for the hospital to actively control the body weight and blood glucose of the patients,rigorously conform to the operation procedures,shorten the operation duration and closely monitor the vital signs so as to reduce the incidence of the po
作者
张园伟
金茂和
相程江
赵东明
唐建刚
ZHANG Yuan-wei;JIN Mao-he;XIANG Cheng-jiang;ZHAO Dong-ming;TANG Jian-gang(Shengzhou People＇s Hospital,Shaoxing,Zhejiang 312400,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第13期1998-2001,共4页
Chinese Journal of Nosocomiology
基金
浙江省卫生科技计划基金资助项目(2016RCB020)
关键词
结直肠癌
切口部位感染
病原菌
相关因素
预防措施
Colorectal cancer
Incision site infection
Pathogen
Related factor
Prevention measure
