胰十二指肠切除患者术后感染影响因素分析

Influencing factors for postoperative infections in patients undergoing pancreaticoduodenectomy

目的探讨胰十二指肠切除术术后感染的影响因素。方法通过医院HIS系统,提取某医院2014-2016年胰十二指肠手术全部病例,比较手术后感染的发生对住院天数、住院费用的影响;利用logistic回归模型,对手术后感染的影响因素进行分析。结果男性发生手术后感染的风险是女性的2.56倍(95%CI:1.127~5.834);开腹手术是手术后感染的保护因素,其OR值0.283(95%CI:0.131~0.614);术中输血超过1 000ml显著增大感染风险(OR=23.537,95%CI:10.927~50.698);年龄、手术时间对手术后感染的发生也有一定影响;发生手术后感染患者,其中位住院日延长5.96d,住院费用增加10.47万元。结论胰十二指肠切除术后感染延长了患者住院天数,增加了疾病负担。男性、腹腔镜和机器人术式、术中输血量超过1 000ml是手术后感染的高危因素,需要严格把握适应证,减少风险。

OBJECTIVE To explore the influencing factors for the postoperative infection in patients undergoing pancreaticoduodenectomy.METHODS The patients who received the pancreaticoduodenectomy from 2014 to 2016 were extracted by means of HIS system,the impact of the postoperative infections on length of hospital stay and hospitalization cost was compared,and the influencing factors for the postoperative infections were analyzed by using logistic regression model.RESULTS The males were 2.56 times the risk of postoperative infection as the females（95%CI：1.127～5.834）;the laparotomy was the protective factor for the postoperative infections,with the OR value 0.283（95%CI：0.131～0.614）.The volume of intraoperative blood transfusion more than 1 000ml significantly increased the risk of infection（OR=23.537,95%CI：10.927～50.698）;the age and operation duration also had certain impact on the incidence of postoperative infections.The length of hospital stay of the patients with postoperative infections extended by 5.96 days,and the hospitalization cost was increased by 104,700 yuan.CONCLUSION The postoperative infections may extend the length of hospital stay and increase the disease burden of the patients undergoing the pancreaticoduodenectomy.The male,laparoscopic and robotic surgery and volume of intraoperative blood transfusion more than 1 000ml are the high-risk factors,and it is necessary to rigidly grasp the indications and reduce the risk.