结肠癌合并肠梗阻患者急诊术后切口感染的病原学与危险因素分析

发布时间：2018-04-10 05:16

  本文选题：结肠癌　切入点：肠梗阻　出处：《中华医院感染学杂志》2017年05期

【摘要】：目的结肠癌合并肠梗阻急诊术后切口感染率较高,严重影响患者术后康复,本文旨在分析结肠癌合并肠梗阻患者急诊术后切口感染的病原学和危险因素,为临床防治结肠癌合并肠梗阻急诊术后感染提供参考。方法回顾性收集2011年1月-2016年6月医院收治的结肠癌合并肠梗阻的患者189例,所有患者均行急诊结肠癌切除术,观察切口感染率,分析患者的病原学和临床特征,并分析切口感染的危险因素。结果 35例患者发生切口感染,共培养出48株细菌,其中革兰阴性菌占62.50%,革兰阳性菌占37.50%;合并糖尿病的患者切口感染率显著增高(44.44%vs14.20%,P=0.000),手术时间≥150min的患者切口感染率显著增高(24.07%vs 11.11%,P=0.013),术前白细胞≥109/L的患者切口感染率显著增高(26.56%vs14.40%,P=0.042);C-反应蛋白≥10mg/L的患者切口感染率显著增加(22.88%vs11.27%,P=0.047);白蛋白30g/L的患者切口感染率显著增加(29.09%vs14.18%,P=0.017);多因素logistic回归分析显示糖尿病、术前白细胞≥109/L、C-反应蛋白≥10mg/L和白蛋白30g/L是结肠癌合并肠梗阻患者术后切口感染的危险因素。结论结肠癌合并肠梗阻患者急诊术后以革兰阴性菌常见,糖尿病、白细胞增高、C-反应蛋白增高和白蛋白降低是结肠癌合并肠梗阻患者急诊术后切口感染的危险因素。
[Abstract]:Objective to analyze the etiology and risk factors of incision infection in colon cancer complicated with intestinal obstruction after emergency operation.To provide reference for clinical prevention and treatment of postoperative infection of colon cancer complicated with intestinal obstruction.Methods 189 patients with colonic cancer complicated with intestinal obstruction were collected retrospectively from January 2011 to June 2016. All patients underwent emergency colon cancer resection. The incision infection rate was observed, and the etiology and clinical features of the patients were analyzed.The risk factors of incision infection were analyzed.Results the infection of incision occurred in 35 patients and 48 strains of bacteria were cultured.The rate of incision infection in patients with diabetes mellitus was significantly higher than that in patients with diabetes mellitus (44.44 vs 14.20) 0.000, and the infection rate of incisions in patients with operation time 鈮，

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