直肠癌术后切口感染影响因素及预防措施

摘要

Objective To explore the influence factors and prevention methods for postoperative incision infection in rectal cancer.Methods Totally 330 patients with rectal cancer after radical resection from January 2010 to December 2013 were enrolled and divided into incision infection group and non-incision infection group.The age,gender,basic disease,body mass index,operation proficiency of surgeons,incidence of hypothermia,time from skin to operation,proportion of emergency operation and length of operation time were compared between the two groups.Results Totally 40 cases had incision infection after operation with an incidence of 12.1％.The age,proportion of basic disease,body mass index,proportion of unskilled surgeon,time from skin preparation to operation,incidence of hypothermia,proportion of emergency operation and length of operation time in incision infection group were higher or longer than those in non-incision infection group [(65 ± 11) years vs (58 ± 14) years,60.0％ (24/40) vs 34.1％ (99/290),(26.2 ± 1.7) kg/m2 vs (24.0 ±2.0) kg/m2,30.0％ (12/40) vs9.0％ (26/290),(15±5) h vs (10±3) h,37.5％ (15/40) vs 22.1％ (64/290),22.5％ (9/40) vs 6.9％ (20/290),(4.1 ± 1.1) h vs (3.1 ± 1.0) h] (P ＜0.05);there was no significant difference in gender between the two groups (P ＞ 0.05).Conclusion The age,body mass index,proficiency of the surgeons,time from skin preparation to operation,hypothermia,emergency operation and operation time are the influence factors of incision infection;measures should be implemented to prevent and control the incision infection in addition to following the principle of aseptic operation.%目的 探讨直肠癌术后切口感染影响因素及预防措施.方法 选择2010年1月至2013年12月浙江省宁波市第九医院及浙江大学医学院附属第一医院诊治的直肠癌根治术患者330例,根据术后有无切口感染分为切口感染组和无切口感染组,比较2组患者年龄、性别、基础疾病、体重指数、术者手术操作熟练程度、低体温症发生情况、备皮距离手术时间、急诊手术、手术时间等因素的差异.结果 330例直肠癌患者术后共40例发生切口感染,发生率12.1％,切口感染组患者平均年龄、合并基础疾病者占比、体重指数、术者手术操作不熟练占比、备皮距离手术时间、低体温症发生率、实施急诊手术者占比、手术时间均高于无切口感染组[(65±11)岁比(58±14)岁、60.0％(24/40)比34.1％(99/290)、(26.2±1.7) kg/m2比(24.0±2.0) kg/m2、30.0％(12/40)比9.0％(26/290)、(15 ±5)h比(10±3)h、37.5％ (15/40)比22.1％(64/290)、22.5％ (9/40)比6.9％(20/290)、(4.1±1.1)h比(3.1±1.0)h],差异均有统计学意义(均P＜0.05),2组患者性别构成比较差异无统计学意义(P＞0.05).结论 年龄、基础疾病、体重指数、术者手术操作熟练程度、低体温症、备皮距离手术时间、急诊手术、手术时间是导致切口感染的影响因素,除遵循无菌操作原则外应实施针对性措施预防和控制切口感染.