结肠直肠恶性肿瘤手术部位感染危险因素分析

发布时间：2018-10-30 09:20

【摘要】：目的评估结肠直肠恶性肿瘤手术部位感染(surgical site infection,SSI)发生率,探讨其危险因素。方法前瞻性调查于2012年9月—2013年9月在重庆医科大学附属第一医院行结肠直肠恶性肿瘤切除术的392例患者,分为SSI组90例和对照组302例,单因素和多因素分析手术部位感染危险因素。结果 SSI组90例,罹患率23.0%。单因素分析显示在手术持续时间75%分位点、是否结肠造瘘、手术方式、手术切口类型、美国麻醉医师学会(ASA)评分两组差异有统计学意义(P0.05),二元Logistic回归分析显示污染手术切口(P=0.016,OR=3.311)、手术持续时间75%分位点(P=0.000,OR=3.017)、结肠造瘘(P=0.008,OR=2.642)、腹腔镜手术(P=0.016,OR=0.523)两组差异有统计学意义。结论手术持续时间75%分位点、结肠造瘘和污染手术切口是结肠直肠恶性肿瘤切除术发生SSI独立的危险因素,而腹腔镜手术方式是保护性因素。
[Abstract]:Objective to evaluate the incidence and risk factors of surgical site infection (surgical site infection,SSI) in colorectal malignant tumors. Methods from September 2012 to September 2013, 392 patients who underwent resection of colorectal malignancies in the first affiliated Hospital of Chongqing Medical University were divided into two groups: SSI group (n = 90) and control group (n = 302). Univariate and multivariate analysis of surgical site infection risk factors. Results there were 90 cases in SSI group, the attack rate was 23.0%. Univariate analysis showed that there were significant differences between the two groups in the operation duration of 75 fractions, whether the colostomy, the operation method, the type of surgical incision, and the (ASA) score of the American Society of Anesthesiologists (P0.05). Binary Logistic regression analysis showed contaminated incision (P0. 016 OR3. 311), operation duration 75 loci (P0. 000 OR3. 017), colostomy (P0. 008 ORV 2. 642), laparoscopic surgery (P0. 016), colonic fistula (P0. 008), laparoscopic surgery (P0. 016). OR=0.523) the difference between the two groups was statistically significant. Conclusion Colostomy and contaminated incision are independent risk factors for the occurrence of SSI in resection of colorectal malignant tumor, while laparoscopic operation is the protective factor.
【作者单位】：重庆医科大学附属第一医院医院感染管理科;重庆医科大学附属第一医院医院心血管内科;重庆医科大学附属第一医院医院胃肠外科;武警重庆市总队医院;
【分类号】：R735.3

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