结肠癌术后并发感染的危险因素调查分析

Risk factors for concurrent infection after colon cancer surgery

目的探讨分析结肠癌术后感染并发症的危险因素。方法选取2006年1月-2011年1月结肠癌手术并发感染的42例患者作为研究对象,对其发生感染的危险因素进行研究分析。结果年龄≥60岁、美国麻醉师协会（ASA）分级Ⅲ~Ⅳ级、有糖尿病、血红蛋白〈110 g/L和总蛋白〈65 g/L、红细胞〈4.0×1012/L的感染率分别为5.39%、13.89%、7.14%、11.54%、10.00%、8.93%,年龄〈60岁、ASA分级Ⅰ~Ⅱ级、无糖尿病、血红蛋白≥110 g/L、总蛋白≥65 g/L和红细胞≥4.0×1012/L的感染率分别为1.73%、3.38%、3.23%、3.33%、3.48%、3.44%,二者差异有统计学意义（P〈0.05）;手术方式（Miles术式）、手工吻合、手术时间≥3 h、未用聚维酮碘冲洗、低血压的感染率分别为6.37%、5.42%、9.22%、5.78%、12.70%,手术方式（Dixon、Hartmann术式）、吻合器吻合、手术时间〈3 h、用聚维酮碘冲洗、不存在低血压的感染率分别为2.60%、4.70%、2.75%、2.48%、1.73%、2.58%。结论结肠癌术后感染并发症的危险因素较多,应引起重视。

OBJECTIVE To study the risk factors for postoperative infection of colon cancer surgery.METHODS A total of 42 patients with postoperative infection of colon cancer surgery in our hospital from Jan 2006 to Jan 2011 were selected as research object,and the risk factors for postoperative infection of colon cancer surgery were studied and analyzed.RESULTS The infection rates of aged ≥60 years old,ASA grade（Ⅲ~Ⅳ grade）,with diabetes,Hb（110 g/L）,total protein（65g/L and RBC（4.0×1012/L） were 5.39%,13.89%,7.14%,11.54%,10.00% and 8.93%,respectively,which were significant higher than those of aged60 years old,ASA grade（Ⅰ~Ⅱ grade）,without diabetes,Hb（≥110 g/L）,total protein（≥65 g/L） and RBC（≥4.0×1012/L） with 1.73%,3.38%,3.23%,3.33%,3.48% and 3.44% in turn,the differences had statistical significance（P0.05）;the infection rates of operation methods（Miles type）,manual anastomosis,time of operation（≥3h）,washed without iodophor,with hypotension were 6.37%,5.42%,9.22%,5.78% and 12.70%,which were significantly higher than those of operation methods（Dixon type and Hartmann type）,stapled anastomosis,time of operation（3 h）,washed with iodophor,without hypotension with 2.60%,4.70%,2.75%,2.48%,1.73% and 2.58% in turn.CONCLUSION The risk factors for postoperative infection of colon cancer surgery is complex,to which it should be paid attention.