结直肠癌患者手术部位感染相关因素分析

Risk factors of surgical site infection in patients with colorectal cancer

目的分析结直肠癌患者手术部位感染状况及引起手术后感染的相关因素。方法选择2009年1月-2016年10月于医院行直肠癌与结肠癌手术的患者450例的临床资料进行回顾性分析,观察患者感染状况,对引起手术后感染的相关因素进行分析。结果 450例患者中发生感染98例,感染率为21.78%,其中直肠癌手术感染患者43例,结肠癌患者感染55例;会阴部位感染18例,腹部感染80例;浅表切口感染72例,深部切口感染19例,器官间隙感染7例;98例感染患者共培养分离病原菌114株,其中革兰阴性菌89株占78.07%,以大肠埃希菌为主;革兰阳性菌25株占21.93%,以金黄色葡萄球菌为主;手术时间,体重指数(BMI),合并糖尿病,临床分期是结直肠癌患者手术部位感染的相关因素(P<0.05)。结论结直肠癌患者术后易在手术部位发生感染,以革兰阴性菌感染为主,应针对感染相关因素予以积极干预。

OBJECTIVE To analyze the infection status of the surgical site of patients with colorectal cancer and the influencing factors of postoperative infection.METHODS The clinical data of 450 patients who underwent rectal cancer and colorectal cancer surgery from Jan.2009 to Oct.2016 were retrospectively analyzed.The status of infection in patients was observed,and the influencing factors of postoperative infection were analyzed.RESULTS There were 98 cases of infection among 450 cases of patients,and the infection rate was 21.78%.Among them,43 cases of patients with colorectal cancer were infected,and 55 cases of patients with colon cancer infection were infected.There were 18 cases of perineal infection,and 80 cases of abdominal infection.There were 72 cases of superficial incision infection,19 cases of deep incision infection and 7 cases of interstitial infection.A total of 114 strains of pathogens were isolated from 98 infected patients.Among them,there were 89 strains of gram-negative bacteria accounting for 78.07%,mainly Escherichia coli,and 25 strains of gram-positive bacteria accounting for21.93%,mainly Staphylococcus aureus.Operative time,body mass index（BMI）,combined with diabetes mellitus,and clinical stage were the related factors of surgical site infection in patients with colorectal cancer（P 〈0.05）.CONCLUSIONColorectal cancer patients are prone to be infected at the operative site after operation.Gram-negative bacteria are the main pathogens.Positive intervention should be given according the risk factors of infection.