胃肠肿瘤患者术后切口感染危险因素分析及预防对策

Risk factors for postoperative incision infections in gastrointestinal tumor patients and prevention countermeasures

目的探讨胃肠肿瘤患者术后切口感染危险因素及相应预防对策,以预防和控制其术后切口感染的发生。方法对2008年5月-2013年5月实施胃肠肿瘤外科手术1050例患者的切口感染进行回顾性调查和前瞻性研究,采用SPSS19.0软件进行统计分析。结果发生术后切口感染70例,感染率为6.67%,共分离出病原菌70株,其中革兰阴性菌45株占64.29%,革兰阳性菌21株占30.00%,真菌4株占5.71%;年龄、肿瘤类型、住院时间、手术季节、手术时间、侵入性操作、切口类型、合并基础疾病、抗菌药物预防性应用和体质量指数等是导致胃肠肿瘤患者发生术后切口感染的主要危险因素(P<0.05)。结论切口感染是胃肠肿瘤患者术后常见并发症,与多种因素有关,应根据其相关危险因素采取积极有效的预防对策,减少切口感染的发生。

OBJECTIVE To discuss the risk factors and corresponding prevention countermeasures of gastrointesti- nal tumor patients with postoperative incision infection, so as to prevent and control the postoperative wound in- fection. METHODS Retrospective investigation and prospective study were performed for 1050 cases of patients with postoperative infections who underwent gastrointestinal cancer surgery from May 2008 to May 2013, then the statistical analysis was carried out with the use of SPSS19.0 software. RESULTS A total of 70 cases occurred post- operative infection of incision, incidence of infection was 6.67%. A total of 70 strains were isolated, among which mainly gram-negative bacteria, 45 strains （64.29%）, gram-positive bacteria 21 strains（30.00%）, 4 strains of fungi （5.71 %） ; Age, tumor type, length of hospital stay, season of operation, length of operation, bedside pro- cedure, types of incision, combined underlying diseases, the prophylactic use of antibiotics, and factors such as body mass index （BMI） were the leading risk factors of postoperative incision infection in gastrointestinal tumor patients（P〈0.05）. CONCLUSION Incision infection is the common postoperative complications in patients with gastrointestinal tumor, which is associated with a variety of factors. According to the main risk factors, effective prevention measures should be taken positively, in order to reduce incision infection.