乳腺癌患者术后切口感染致病菌病原学特点及危险因素分析

发布时间：2018-12-28 07:34

【摘要】：目的研究乳腺癌患者术后切口感染的病原菌分类及感染相关危险因素,为预防术后切口感染提供参考依据。方法选取本院2012年10月至2015年10月收治的1242例行乳腺癌手术的患者为研究对象,对发生切口感染38例患者感染部位的分泌物进行细菌学培养。统计患者术后切口感染发生率并对相关危险因素进行统计学分析。结果乳腺癌患者术后切口感染发生率为3.06%;切口感染部位检出43株病原菌,其中革兰阴性菌24株(55.8%),革兰阳性菌19株(44.2%);耐药发生以革兰阴性菌为主。统计显示:年龄≥60岁(P=0.044)、临床分期Ⅲ期以上(c TNM)(P=0.013)、行标准根治术或扩大根治术(P=0.032)、营养水平差(血清白蛋白35 g/L)(P=0.012)、伴有糖尿病(P=0.006)、外周血白细胞计数4×10~9个/L(P=0.001)、细胞免疫功能低下(外周血T细胞总数及CD4~+T细胞数降低)(P=0.012)、手术时间≥3小时(P=0.004)、引流时间≥15天(P=0.032)及术前接受辅助化疗(P=0.022)是乳腺癌患者术后发生切口感染的危险因素。结论乳腺癌术后切口感染原因复杂,术中加强感染控制,围术期加强营养支持、积极控制血糖,并给予患者免疫治疗及合理使用抗生素均有助于降低术后切口感染发生率。
[Abstract]:Objective to study the classification and risk factors of postoperative incision infection in breast cancer patients, and to provide reference for prevention of postoperative incision infection. Methods from October 2012 to October 2015, 1242 patients undergoing breast cancer surgery were selected as study subjects, and the secretion of 38 patients with incisional infection was cultured by bacteriology. The incidence of postoperative incision infection and related risk factors were analyzed statistically. Results the incidence of incision infection was 3.06% in breast cancer patients, and 43 strains of pathogenic bacteria were detected in the site of incision infection, of which 24 were Gram-negative bacteria (55.8%), 19 were Gram-positive bacteria (44.2%). Gram-negative bacteria were the main drug resistant bacteria. Statistics showed that age 鈮，

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