择期开腹结直肠癌患者术后切口感染的病原学特点及炎性因子表达分析

发布时间：2018-07-09 09:27

本文选题：择期 + 结直肠癌　；参考：《中华医院感染学杂志》2017年11期

【摘要】：目的研究择期开腹结直肠癌患者术后切口感染的病原学特点,并分析其相关炎性因子表达情况。方法选择2011年3月-2015年5月医院接受治疗的结直肠癌患者160例,采用全自动细菌培养仪以及纸片扩散法(K-B法)对患者切口感染的病原菌及药敏性进行培养和监测;在感染治疗前后采集患者静脉血,对其白介素以及其它炎性因子表达水平进行分析。结果 160例开腹结直肠癌患者术后切口感染28例,感染率为17.5%;28例感染患者共分离出病原菌42株,其中以革兰阴性菌为主占64.3%;革兰阴性菌中大肠埃希菌和铜绿假单胞菌对头孢曲松和头孢唑肟的耐药率高达80.0%以上,对头孢吡肟的耐药率也达50.0%以上;患者感染治疗前白介素及其他炎性因子的水平均较高,治疗3d、7d后患者白介素水平和其他炎性因子水平下降最快,尤以第7天明显,差异有统计学意义(P0.05)。结论对患者进行抗炎治疗时要依据药敏试验结果联合用药,同时密切观察患者机体炎性水平变化,有利于改善患者预后、减轻患者经济负担,值得临床推广。
[Abstract]:Objective to study the etiological characteristics of postoperative incision infection in patients with elective open colorectal cancer and to analyze the expression of inflammatory factors. Methods 160 patients with colorectal cancer who received hospital treatment from March 2011 to May 2015 were selected to culture and monitor the pathogenic bacteria and drug sensitivity of incision infection by using automatic bacterial culture instrument and disk diffusion method (K-B method). The levels of interleukin and other inflammatory factors were analyzed before and after infection treatment. Results there were 28 cases of incision infection in 160 patients with open colorectal cancer. The infection rate was 17.5%. 42 strains of pathogenic bacteria were isolated. The resistance rates of Escherichia coli and Pseudomonas aeruginosa to ceftriaxone and cefazoxime were 80.0% and 50.0% respectively. The levels of interleukin and other inflammatory factors were higher before infection treatment. The levels of interleukin and other inflammatory factors decreased fastest after 3 days of treatment, especially on the 7th day, the difference was statistically significant (P0.05). Conclusion the combination of drug sensitivity test and close observation of the inflammatory level can improve the prognosis and reduce the economic burden of the patients. It is worth popularizing in clinic.
【作者单位】：安徽医科大学第一附属医院胃肠外科;解放军第113医院普外科;
【基金】：国家自然科学基金资助项目(81572305)
【分类号】：R735.34

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