结直肠癌患者根治术后医院感染与吻合口瘘的相关性研究

Relationship between postoperative nosocomial infections and anastomotic fistula of colorectal cancer patients undergoing radical resection

目的研究结直肠癌患者根治术后医院感染与吻合口瘘的相关性研究,降低结直肠癌根治术的医院感染率。方法回顾性分析2011年1月-2013年6月920例结直肠癌根治术患者临床资料,术后发生吻合口瘘的43例患者为吻合口瘘组,未发生吻合口瘘的877例患者为非吻合口瘘组,比较两组患者的治疗结果,分析结直肠癌患者根治术后医院感染与吻合口瘘的相关性。结果 920例患者发生医院感染的有43例,感染率为4.67%,吻合口瘘组患者发生感染32例感染率43.24%,非吻合口瘘组患者发生感染11例,感染率1.30%;两组差异有统计学意义(P<0.05);吻合口瘘组患者感染部位分别为泌尿系、手术切口、腹腔、盆腔及下呼吸道感染分别占12.50%、6.25%、12.50%、31.25%及37.50%,非吻合口瘘组患者分别占9.10%、0、18.18%、36.36%及36.36%,两组差异有统计学意义(P<0.05)。结论结直肠癌根治术后发生吻合口瘘的患者更易发生医院感染,并且感染部位好发于呼吸道与盆腔。

OBJECTIVE To study the relationship between nosocomial infections and anastomotic fistula of the colo‐rectal cancer patients after the radical resection so as to reduce the incidence of nosocomial infections in the colorec‐tal cancer patients undergoing radical resection .METHODS The clinical data of 920 colorectal cancer patients who underwent the radical resection surgery from Jan 2011 to Jun 2013 were retrospectively analyzed ;43 patients with postoperative anastomotic leak were assigned as the anastomotic leak group ,while 877 patients without postopera‐tive anastomotic leak were set as the non‐anastomotic leak group ;the curative effect was observed and compared between the two groups ,and the relationship between postoperative nosocomial infections and anastomotic leak of the colorectal cancer patients undergoing radical resection was analyzed .RESULTS The nosocomial infections oc‐curred in 43 of 920 patients with the infection rate of 4 .67% ,including 32 （43 .24% ） cases of infections in the anastomotic fistula group and 11 （1 .30% ） cases of infections in the non‐anastomotic fistula group ,there was sig‐nificant difference between the two groups （P〈 0 .05） .The patients with urinary tract infections accounted for 12 .50% in the anastomotic fistula group ,9 .10% in the non‐anastomotic fistula group ;the patients with surgical incision infections accounted for 6 .25% in the anastomotic fistula group ,0 in the non‐anastomotic fistula group ;the patients with abdominal infections accounted for 12 .50% in the anastomotic fistula group ,18 .18% in the non‐anastomotic fistula group ;the patients with pelvic infections accounted for 31 .25% in the anastomotic fistula group ,36 .36% in the non‐anastomotic fistula group ;the patients with lower respiratory tract infections accounted for 37 .50% in the anastomotic fistula group ,36 .36% in the non‐anastomotic fistula group ,there was significant difference between the two groups （P〈0 .05） .CONCLUSION The colorectal cancer patients with anastomotic leak tend to have the nosocomial infections after the radical resection ,and the respiratory tract and pelvic cavity are the predilection sites of infections .