摘要
目的探讨结直肠癌合并肠梗阻术后切口病原菌及危险因素。方法回顾性分析2013年1月～2018年4月在廉江市人民医院普通外科治疗的结直肠癌合并肠梗阻患者151例。查阅统计病原微生物鉴定结果,根据是否发生切口感染将患者分为感染组和非感染组,采用多因素Logistic回归分析其独立危险因素。结果感染的发生率为19.87%(30例),一共检出52株病原微生物,其中革兰阴性菌、革兰阳性菌和真菌分别占57.695%(30株),34.62%(18株)和7.69%(4株)。多因素Logistic回归分析显示糖尿病(OR=5.861,95%CI=1.705～20.153,P=0.005)、行支架植入一期吻合术(OR=0.084,95%CI=0.022～0.330,P=0.000)、术中低血压(OR=3.844,95%CI=1.103～13.396,P=0.035)与切口感染关系密切。结论直肠癌合并肠梗阻术后切口的病原菌众多,糖尿病和术中低血压是切口感染的独立危险因素,而行支架植入一期吻合术则是保护因素。
Objective To explore postoperative incision pathogenic bacteria and risk factors in colorectal cancer complicated with intestinal obstruction.Methods 151 patients with colorectal cancer complicated with intestinal obstruction received in General Surgery of Lianjiang People's Hospital during January 2013 to April 2018 were collected as the subjects.After checking the statistical identification results of pathogenic microorganisms,the patients were divided into the infected group and the non-infected group depending on whether or not incision infection occurs.Multivariate Logistic regression was used to analyze the independent risk factors.Results The incidence rate of infection was 19.87%(30 cases).A total of 52 strains of pathogenic microorganisms were detected,among which the gram-negative bacteria,gram-positive bacteria and fungi accounted for 57.695%(30 strains),34.62%(18 strains)and 7.69%(4 strains),respectively.Diabetes(OR=5.861,95%CI=1.705-20.153,P=0.005),stent implantation performed with one-stage anastomosis(OR=0.084,95%CI=0.022-0.330,P=0.000)and intraoperative hypotension were closely related to incision infection with Multivariate Logistic regression analysis.Conclusion Postoperative incision of rectal cancer complicated with intestinal obstruction has many pathogenic bacteria.Diabetes mellitus and intraoperative hypotension are independent risk factors for incision infection,while primary stenting is a protective factor.
作者
吴培信
林木本
孙相钊
陈子彪
WU Peixin;LIN Muben;SUN Xiangzhao;CHEN Zibiao(Department of General Surgery,Lianjiang People's Hospital,Guangdong Province,Lianjiang 524400,China;Department of Digestive internal medicine,Lianjiang People's Hospital,Guangdong Province,Lianjiang 524400,China)
出处
《中国医药科学》
2019年第2期21-24,共4页
China Medicine And Pharmacy
基金
广东省医学科研基金项目(A2014766)
广东省湛江市科技计划项目(2016B01069)
关键词
结直肠癌
肠梗阻
病原菌
危险因素
切口感染
Colorectal cancer
Intestinal obstruction
Pathogenic bacteria
Risk factors
Infection of incision
