腹腔镜胃癌根治术后发生感染的危险因素研究

Study on Risk Factors of Infection after Laparoscopic Radical Gastrectomy for Gastric Cancer

目的探究腹腔镜胃癌根治术后发生术后感染的危险因素,进行相关因素分析,为防治胃癌术后感染提供临床证据。方法回顾性收集吉林市人民医院2010年1月~2017年10月收治的腹腔镜胃癌根治术患者,共收集278例患者临床资料,并利用统计软件分析腹腔镜胃癌根治术后感染与性别、年龄、体重身高指数(bodymass index,BMI)、美国麻醉协会评分(american society of anesthesiologists,ASA)、手术时间、术中出血量、输血、留置尿管时间和术后住院时间的关系。结果 278例腹腔镜胃癌根治术后感染患者为39例,感染率为(14.1%)。单因素分析结果显示手术时间、术中出血量、留置尿管时间与术后感染发生与否相关,且相关性具有统计学意义(P<0.05)。Logistic回归分析揭示手术时间(OR=2.236,P=0.017)、术中出血量(OR=1.611,P=0.037)和留置尿管时间(OR=3.313,P=0.028)是腹腔镜胃癌根治术后感染发生的独立危险因素。结论腹腔镜胃癌根治术后感染是多因素作用的结果,临床医生可通过缩短手术时间、减少术中出血量和减少留置尿管时间来预防和降低腹腔镜胃癌根治术后感染的发生率。

Objective To explore the risk factors of postoperative infection after laparoscopic radical gastrectomy and to analyze the related factors to provide clinical evidence for the prevention and treatment of postoperative infection of gastric cancer. Methods The data retrospectively collected the center from January 2010 to October 2010 were laparoscopic gastric cancer patients with radical prostatectomy, altogether collected clinical data of 278 patients. By using statistical software to analyze the rate of postoperative infection with gender, age, weight, height Index（Body Mass Index, BMI）, the American association of anesthesia score（American Society of Anesthesiologists, ASA）, operation time, intraoperative blood loss, blood transfusion. In addition, it also includes the length of stay and the time of placing a urinary catheter. Results The infection rate in 278 patients with laparoscopic radical gastrectomy was 39, and the infection rate was 14.1%.The results of single factor analysis showed that the time of operation, intraoperative blood loss and indwelling catheter time were correlated with the occurrence of postoperative infection, and the correlation was statistically significant（P 0.05）.Logistic regression analysis revealed that the operation time, intraoperative blood loss, and the retention of urinary catheter were independent risk factors for postoperative infection of laparoscopic gastric cancer. Conclusion Although, laparoscopic gastric cancer effect a radical cure postoperative infection is the result of many factors, clinical doctor can shorten the operation time, reduce intraoperative blood loss and the time placing a urinary catheter to prevent and reduce the incidence of infection.