结直肠癌手术部位感染的危险因素分析

摘要

Objective To analyze the characteristics of the pathogens causing incision infections as well as the infection factors in the patients undergoing colorectal cancer surgery,so as to reduce the incidence of surgical site infection. Methods Retrospectively analyzed the data of 298 cases undergoing colorectal cancer surgery in 2015. Univariate and multiple logistic regression analysis were used to identify any related factors of SSI and bacterial cultured for the wound secretions or abdominal incision secretion drainage fluid to determine the infection of pathogenic bacteria. Results E. coli was the main pathogenic bacteria in surgical site,about 70.83%;single factor analysis showed that body mass index,high blood sugar,traditional open operation,long duration of surgery were risk factors for surgical site infection(P<0.05).Multivariate logistic regression analysis revealed body mass index≥24(P=0.016),operative time≥3.5h(P=0.004),the traditional way of open surgery(P=0.007)were risk factors for surgical site infection. Conclusion The main bacteria for SSI is E. coli. High blood sugar,high body mass index,long hours of surgery and traditional open operation way are risk factors for SSI of colorectal cancer surgery.%目的 分析结直肠癌手术部位感染病原菌分布及影响感染的相关因素,以减少切口感染的发生.方法 回顾性分析2015年全年行结直肠癌择期手术的298例病例资料,对可能影响切口感染的相关因素进行单因素和多因素分析,并对切口感染患者的切口分泌物或者腹腔引流液进行细菌培养,确定感染病原菌.结果 感染患者中的病原菌检出以大肠埃希菌最多,达70.83%;单因素分析表明体重指数、高血糖、传统开腹手术方式、手术持续时间长是术后感染的危险因素(P<0.05);多因素分析显示体重指数≥24(P=0.016)、手术持续时间≥3.5h(P=0.004)、传统开腹手术方式(P=0.007)为手术部位感染的危险因素.结论 结直肠癌手术部位感染的主要病原菌为大肠埃希菌,高血糖、高体重指数、手术时间长和传统开腹手术方式是术后感染的危险因素.