胃大部切除术后感染的危险因素调查

Investigation of risk factors of infections after gastrectomy

目的调查分析胃大部切除术后感染的危险因素。方法查阅患者病史、病程记录、化验单、特殊检查和细菌学检查报告等资料,观察患者年龄、性别、有无糖尿病、是否合并其他基础疾病、术前ASA分级、手术方式、手术切口清洁程度、手术时机、手术时间、术中输血情况、术前预防性使用抗菌药物情况等。结果共574例胃大部切除术患者,发生术后感染33例,感染率为5.8%;感染部位为腹腔感染11例、切口感染9例,腹腔、伤口联合感染8例,全身性感染5例,胃大部切除术后感染的单因素分析结果为年龄、性别、合并其他基础疾病、手术时机、术前应用抗菌药物、术中输血以及手术时间为术后感染的危险因素。结论术后感染发生与性别、高龄、患有糖尿病、合并基础疾病、ASA分级评分较高、切口清洁度、急诊手术相关。

OBJECTIVE To investigate and analyze the risk factors of infections after gastrectomy.METHODS The medical histories of patients,progress notes,laboratory test,special inspection and bacteriological inspection reports and other information were retrospectively reviewed.The patients＇ age,gender,with or without diabetics,with or without other underlying diseases,preoperative ASA classification,surgical approaches,hygiene of surgical incision,time of surgery,operating time,intraoperative blood transfusion,preoperative prophylactic use of antibiotics and so on were investigated.RESULTS A total of 33 cases of 574 patients after gastrectomy were infected,with the infection rate of 5.8%.Eleven cases were found having abdominal infection,9 cases having incision infections,8 cases having abdominal combined with incision infection,5 cases having systemic infections.Univariate analysis showed that age,sex,with or without underlying diseases,time of surgery,use of preoperative antibiotics,intraoperative blood transfusion,and operating time were the risk factors for infections after gastrectomy.CONCLUSION Postoperative infection are related to gender,age,diabetes,combined basic diseases,high ASA classification score,incision hygiene and emergency surgery.