腹腔镜手术后患者感染病原菌分布及外周血细胞因子改变研究

发布时间：2018-02-27 16:11

本文关键词： 腹腔镜手术感染情况病原菌分布外周血细胞因子　出处：《中华医院感染学杂志》2017年12期 　论文类型：期刊论文

【摘要】：目的调查腹腔镜手术患者的感染情况,进一步分析患者感染病原菌分布特征及外周血细胞因子的变化。方法选取2013年12月-2015年12月临床收治的腹腔镜手术患者643例,针对腹腔镜手术患者术后感染发生情况进行统计,并采用单因素分析和多因素回归分析统计腹腔镜手术患者术后感染的危险因素,对导致患者感染致病菌进行检测,同时,对非感染和感染患者的外周血细胞因子(IL-8、IL-1β、IL-6、IL-10、TNF-α和IL-12p70)水平进行观察和比较。结果 643例腹腔镜手术患者术后发生感染64例,感染率为9.95%;logistic分析证实肺部疾病、低蛋白血症、手术时间、体质量指数、糖尿病和胃肠功能恢复时间是导致腹腔镜手术患者术后感染的独立危险因素;64例术后感染患者共检出致病菌81株,革兰阴性菌、革兰阳性菌和真菌分别占66.66%、28.40%和4.94%;感染患者IL-8、IL-1β、IL-6、IL-10、TNF-α和IL-12p70等各项因子水平均明显高于非感染患者,差异有统计学意义(P0.05)。结论腹腔镜手术患者术后感染应得到临床重视,导致患者术后感染的致病菌以革兰阴性菌为主,手术时间、体质量指数、住院时间、糖尿病、肺部疾病、低蛋白血症和胃肠功能恢复时间等是导致患者术后感染的危险因素,感染患者外周血细胞因子水平会显著升高。
[Abstract]:Investigation of infection in patients undergoing laparoscopic surgery to further analyze the changes of pathogenic bacteria distribution and infection in patients with peripheral blood cytokines. 643 patients underwent laparoscopic surgery methods from December 2013 admitted to our hospital in December -2015 years, according to the occurrence statistics of infected patients after laparoscopic operation, and regression analysis of risk factors for infection in patients undergoing laparoscopic surgery statistics after the single factor analysis and multi factor, also lead to pathogen detection, infection of uninfected and infected patients with peripheral blood cytokines (IL-8, IL-6, IL-10, IL-1 beta, TNF- alpha and IL-12p70) levels were observed and compared. Results 643 cases of patients with laparoscopic surgery after infection in 64 cases, the infection rate was 9.95%; logistic analysis confirmed that the lung disease, hypoproteinemia, operation time, body mass index, diabetes and gastrointestinal function recovery time is the result of Independent risk factors for infection in patients after laparoscopic surgery; 64 cases of postoperative infection were detected in 81 strains of pathogenic bacteria, gram negative bacteria, gram positive bacteria and fungi accounted for 66.66%, 28.40% and 4.94%; infection in patients with IL-8, IL-6, IL-10, IL-1 beta, TNF- alpha and IL-12p70 for the sub level significantly higher than non infected patients, the difference was statistically significant (P0.05). Clinical attention should be infected patients conclusion after laparoscopic surgery in patients with postoperative infection of pathogenic bacteria to gram negative bacteria, operation time, hospitalization time, body mass index, diabetes, lung disease, hypoproteinemia and gastrointestinal function the recovery time is a risk factor for infection after surgery, blood levels of cytokines in patients with peripheral infection significantly increased.

【作者单位】：浙江省青春医院普外科;浙江大学附属第二医院肿瘤外科;
【基金】：国家自然科学基金面上项目(81472819)
【分类号】：R656

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