乳腺癌改良根治术后手术切口及引流管感染的危险因素分析

Research on the risk factors of operative incision and drainage infection after the improved radical correction of breast cancer

目的:探讨乳腺癌改良根治术后手术切口及引流管感染的危险因素。方法:纳入我院实施乳腺癌改良根治术的患者137例,对患者围手术期相关临床资料进行回顾性研究。分析导致患者术后手术切口及引流管感染发生的致病菌,并对相关危险因素进行比较。结果:137例乳腺癌改良根治术患者中,有22例术后出现手术切口及引流管感染,发生率为16.06%。致病菌方面,22例患者共分离出致病菌29株,革兰阳性菌与革兰阴性菌导致的感染分别占68.97%、31.03%。药敏试验显示,革兰阳性菌对万古霉素及利福平的敏感性较高,而革兰阴性菌则对亚胺培南有较高的敏感度。患者合并糖尿病、体质量指数(BMI)≥25kg/m2、普通负压引流以及置管时间≥10d等均是导致乳腺癌改良根治术后手术切口及引流管感染发生的高危因素(P<0.05)。结论:乳腺癌改良根治术后患者发生手术切口及引流管感染较为常见。导致感染的因素包括糖尿病、BMI≥25kg/m2、普通负压引流以及置管时间≥10d等。通过细菌培养及药敏试验,选择针对致病菌合适的抗菌药物,对治疗感染有着重要的临床意义。

Objective：To study the risk factors of operative incision and drainage infection after the improved radical correction of breast cancer. Methods：The clinical data about 137 patients of adopting the improved radical correction of breast cancer in our hospital was retrospectively reviewed to analyze the pathogenic factors and risk factors of operative incision and drainage infection. Results：There were 22 cases with operative incision and drainage infection（ 16. 06%）. 29 strains of pathogenic bacteria were extracted of which the infection rate of gram- positive bacteria and gram- negative bacteria was 68. 97% and 31. 03%. According to the drug sensitive test,the sensitivity of gram- positive bacteria on Vancomycin and Rifampicin was higher. The sensitivity of gram- negative bacteria on Imipenem was higher. The high risk factors of operative incision and drainage infection were complications of diabetes,BMI,rate of natural drainage and indwelling time（ P 0. 05）. Conclusion：After the improved radical correction of breast cancer,it is easy to cause the operative incision and drainage infection. Its risk factors are complications of diabetes,BMI,rate of natural drainage and indwelling time. It is of great importance to select the proper antibacterial agents through the bacterial culture and drug sensitive test.