结直肠癌患者手术切口感染因素及预防对策

Risk factors for surgical incision infections in colorectal cancer patients and prevention countermeasures

目的探讨结直肠癌患者手术切口感染因素及预防对策,以降低手术切口感染率。方法对2008年5月-2011年8月收治的592例结直肠癌手术患者进行回顾性分析,按照其切口感染分为感染组113例及非感染组479例,对比两组患者一般资料,对影响感染组切口感染的危险因素进行logistic多因素回归分析,并制定预防对策。结果 592例结直肠癌患者中113例出现手术切口感染,感染率19.1%;一般资料分析中,其体重指数(BMI)、合并糖尿病、手术时间、出血量及抗菌药物使用时间,差异有统计学意义(P<0.05);多因素logistic回归分析发现,BMI<23、存在合并糖尿病、手术时间>150min及抗菌药物使用>3d是影响结直肠癌患者手术切口感染的独立危险因素(P<0.05)。结论 BMI<23、存在合并糖尿病、手术时间>150min及抗菌药物使用>3d是影响结直肠癌患者手术切口感染的独立危险因素,应行术前营养支持、稳定血糖水平、缩短手术时间、合理应用抗菌药物,并实施围术期保暖措施,以降低感染风险,提高患者生存质量。

OBJECTIVE To explore the risk factors for surgical incision infections in the colorectal cancer patients and put forward prevention countermeasures so as to reduce the incidence of surgical incision infections.METHODS A total of 592cases of colorectal cancer patients who were treated in the hospital from May 2008to Aug 2011were retrospectively analyzed,then the patients were divided into the infection group with 113cases and the non-infection group with 479cases according to the status of surgical incision infections,the general data were compared between the two groups,then the multivariate logistic regression analysis were performed for the risk factors of the incision infections so as to put forward the prevention countermeasures.RESULTS Of totally 592 cases of patients with colorectal cancer,the surgical incision infections occurred in 113patients with the infection rate of 19.1%.Through the analysis of the general data,the difference in the body mass index（BMI）,complication of diabetes,operation duration,bleeding volume,or time of use of antibiotics was significant（P0.05）;the multivariate logistic regression analysis indicated that the BMI less than 23,complication of diabetes,operation duration more than 150min,and time of use of antibiotics more than three days were the independent risk factors for surgical incision infections in the patients with colorectal cancer（P0.05）.CONCLUSIONThe BMI less than 23,complication of diabetes,operation duration more than 150min,and time of use of antibiotics more than 3 days are the independent risk factors for the surgical incision infections in the patients with colorectal cancer.It is necessary to perform the preoperative nutrition support,stabilize the blood sugar level,shorten the operation duration,reasonably use antibiotics,and implement the perioperative measures to keep warm so as to reduce the risk of infections and improve the life quality.