胃肠肿瘤患者术后切口感染危险因素分析

Risk factors for postoperative incision infections in patients with gastrointestinal cancer

目的研究胃肠肿瘤患者术后切口感染危险因素及护理对策,为进一步降低胃肠肿瘤患者术后切口感染发生率,提高手术治疗效果。方法选取2015年1-9月医院诊治的500例胃肠肿瘤患者临床资料,分析发生切口感染患者的危险因素,数据采用SPSS 18.0软件进行统计分析。结果 500例胃肠肿瘤手术患者中有70例发生切口感染,感染率为14.00%;共分离出70株病原菌,以革兰阴性菌为主,共45株占64.29%;多因素logistic结果显示,年龄>60岁、住院时间≥14d、恶性肿瘤、夏季手术、手术时间>2h,有侵入性操作、基础疾病及预防用药等为胃肠肿瘤手术患者切口感染的独立危险因素(P<0.05)。结论胃肠肿瘤患者术后切口感染危险因素较多,应该采取有效的措施进行预防、治疗,降低患者术后切口感染发生率。

OBJECTIVE To explore the risk factors for postoperative incision infections in patients with gastrointestinal cancer and put forward the nursing countermeasures so as to further reduce the＇incidence of the postoperative incision infections and improve the surgical therapeutic effect. METHODS The data were collected from 500 gastrointestinal cancer patients who were treated in the hospital from Jan 2015 to Sep 2015, then the risk factors for the incision infections were analyzed, and the statistical analysis of data was performed with the use of SPSS 18.0 software. RESULTS Of 500 gastrointestinal cancer patients undergoing surgeries, 70 had incision infections with the infection rate of 14.00%. A total of 70 strains of pathogens were isolated, of which 45 （64.29%） were gramnegative bacteria. The multivariate logistic regression analysis indicated that the independent risk factors for the incision infections in the gastrointestinal cancer patients included the more than 60 years of age, length of hospital stay no less than 14 days, malignant tumor, surgery in summer, operation duration more than 2 hours, invasive operation, underlying disease, and antibiotic prophylaxis （P〈0.05）. CONCLUSION There are a variety of risk factors for the postoperative incision infections in the gastrointestinal cancer patients. It is necessary to take effective prevention measures so as to reduce the incidence of the postoperative incision infections.