直肠癌患者术后切口感染影响因素及护理措施

Influencing factors and nursing strategies for postoperative incision infection in patients with rectal cancer

目的探讨直肠癌患者术后切口感染相关影响因素及护理措施。方法选取2015年4月至2017年4月间四川省简阳市人民医院收治的80例直肠癌患者,均接受手术治疗,且术后出现切口感染。收集患者的各项临床资料进行单因素分析和多因素回归分析,探讨术后切口感染的影响因素,并分析相应的临床护理方案。结果直肠癌患者术后切口感染相关影响因素中,合并糖尿病、身体体质指数≥25kg/m2、术中输血、术前有低蛋白血症、手术方式为开腹和手术时间≥150min患者,术后切口感染率均高于未合并糖尿病、平均体质指数<25kg/m2、术中未输血、术前无低蛋白血症、手术方式为腹腔镜和手术时间<150min的患者,差异均有统计学意义(均P<0.05)。直肠癌患者术后切口感染的独立影响因素包括术前低蛋白血症、手术时间和手术方式,差异均有统计学意义(均P<0.05)。结论直肠癌患者术后切口感染相关影响因素包括术前低蛋白血症、手术时间和手术方式,积极改善患者术前营养状态、推广腔镜技术及缩短手术时间,可减少术后切口感染率。

Objective To explore the related factors of postoperative incision infection in rectal cancer patients,and analyze the corresponding nursing measures. Methods A total of 80 patients with rectal cancer were selectedat Jianyang People＇s Hospital from April 2015 to April 2017. All patients underwent surgical treatment,and postoperative incision infection. The clinical data of the patients were collected,and Univariable analysis and multiple regression analysis were conducted to explore the factors influencing postoperative incision infection,and to analyze the corresponding clinical nursing plan. Results Patients with diabetes mellitus,average body mass index greater than 25 kg/m^2,intraoperative blood transfusion,preoperative hypoalbuminemia,surgical laparotomy,operation time more than 150 min had significantly higher postoperative incision infection rate than those without diabetes,the average BMI 25 kg/m^2,without intraoperative blood transfusion,preoperative hypoproteinemia,laparoscopic operation mode and operation time 150 min（ all P〈0. 05）. Factors influencing postoperative incision infection in rectal cancer patients included preoperative hypoproteinemia,operation time and operation mode（ all P〈0. 05）. Conclusion Related factors for postoperative incision infection in rectal cancer patients include preoperative hypoproteinemia,operation time and mode of operation. To actively improve the nutritional status of patients before surgery,promot endoscopic technology and shorten the operation time may help reduce postoperative incision infection rate.