结直肠癌不同手术方式术后引流液分离阳性率与SSIs的相关性分析

Association of Perioperative Susceptible Strains and Colorectal Cancer Surgical Procedures

目的探讨结直肠癌采用不同手术方式与易感菌株细菌分布的相关性,以及术后手术部位感染(Surgical Site Infections,SSIs)发生与易感菌株关系。方法采集本院164例确诊为结直肠癌手术患者的术后引流液进行细菌培养,按照美国临床和实验标准化研究所制定的指导原则进行结果判断,并采用统计方法对所取标本相应的手术方式与易感菌株、术后SSIs发生进行相关性分析。结果引流液各组标本分离细菌以革兰阴性菌(G-)为主。4组手术方式中的引流液细菌分离阳性率不全相同(P=0.031),其中左半结肠切除术+乙状结肠切除术组、经腹直肠癌前切除术组(Dixon’s术组)较高,分别占36.0%(9/25)、32.6%(29/89)。总体SSIs发生率为6%(10/164),以Dixon’s术组较高(7/89)。其样本分离菌株以大肠埃希菌为主。Dixon’s术引流液细菌分离阳性率与术后SSIs的发生有关联性(P<0.05)。结论不同手术方式易感菌株的来源主要以大肠埃希菌为代表的G-菌为主,结直肠癌手术方式与易感菌株引起术后SSIs存在一定关联性。

Objective To explore the association of perioperative susceptible strains and colorectal cancer surgical procedures,and to analyze the relationship between surgical site infections（ SSIs） and susceptible strains. Methods The drainage fluid from 164 consecutive colorectal cancer patients after operation were cultured. The cultured results were determine by the principles of the instructions for Clinical and Experimental Institute for Standardization. The statistical methods,logistic regression and correlation were performed to evaluate the association between surgical procedure,susceptible strains,and SSIs. Results The isolated bacteria were mainly G-bacteria in the 4 surgical groups. The positive rate of bacterial culture from fluid in 4 groups were not the same（ P = 0. 031）. The left colectomy ＋ sigmoid resection group and premenstrual abdominal colorectal cancer resection group（ ie Dixon＇s surgery group） were higher,accounting for 36. 0%（ 9 /25）,32. 6%（ 29 /89）. Incidence of SSIs was 6%（ 10 /164） in total,with the highest in Dixon＇s surgery group（ 7 /89）. The bacteria were mainly E. coli. Correlation analyses indicated that SSIs was related to positivity of fluid bacterial culture in Dixon＇s surgery group（ P〈0.05）. Conclusion Susceptible strains are mainly G-bacteria,most of which are E. coli. Therefore,the mode of surgical procedure is associated with SSIs caused by susceptible strains.