乳腺癌患者术后手术部位感染相关危险因素分析

Related risk factors for postoperative surgical site infections in breast cancer patients

目的探讨影响乳腺癌患者术后发生手术部位感染的相关因素,为临床预防手术部位感染提供依据。方法回顾性分析2005-2011年因乳腺癌行外科手术治疗的289例患者临床资料,按是否发生术后感染分为感染组45例及非感染组244例,系统收集相关资料并运用统计方法对各项指标进行检验,找出潜在危险因素,并对各手术方式进行感染率的评价。结果 289例患者发生手术部位感染45例,感染率15.6%,两组患者其主要危险因素包括患有糖尿病31.1%与12.0%(P<0.01)、吸烟20.0%与10.5%(P<0.01)、活动性皮肤疾病17.8%与2.5%(P<0.01),其余相关因素包括临床分期较晚(P=0.001)及接受新辅助治疗40.0%与19.7%(P=0.003);另外保乳手术相对于其他手术方式发生手术部位感染的概率更低13.3%与86.7%%(P<0.01)。结论乳腺癌术后手术部位感染的危险因素既有基础指标又有手术相关指标,对相应因素的控制可减少术后手术部位感染的发生率。

OBJECTIVE To explore the related factors for the postoperative surgical site infections in the breast cancer patients so as to provide basis for the clinical prevention of the surgical site infections. METHODS The clinical data of 289 breast cancer patients who underwent surgery during 2005- 2011 were retrospectively analyzed, then the subjects were divided into the infection group with 45 cases and the non-infection group with 244 cases according to the status of postoperative infections, the relevant data were statistically analyzed to examine the indicators and find out the risk factors, and the infection rates of different surgery approaches were assessed. RESULTS Of totally 289 cases of patients investigated, the surgical site infections occurred in 45 cases with the infection rate of 15.6 %. The main risk factors for the surgical site infections in the two groups of patients included the complication of diabetes （31.1% vs 12.0%, P〈0.01）, smoking history （20.0% vs 10.5%, P〈0.01）, and active skin disorders （17.8% vs 2.5%, P〈0.01）, other related factors included the advanced clinical stage （P=0. 001） and neoadjuvant therapy （40.0% vs 19.7% ,P=0. 003）. Additionally, as compared with other surgical procedures, the incidence of the surgical site infections was far lower in the breast-conserved surgery （13.3% vs 86.7% %, P%O, 01）, CONCLUSION The risk factors for the postoperative surgical site infections in the breast cancer patients include both the basic indicators and the surgery-related indicators; to control the related factors may reduce the incidence of postoperative surgical site infections.