结直肠癌切除术患者发生手术切口感染的相关因素研究

The research on the related factors of surgical site infections in patients with colorectal cancer resection

目的评价结直肠癌切除术患者发生手术切口感染(SSIs)的相关因素。方法选取在我院进行手术治疗的396例直肠癌切除术患者的临床资料,将患者分为SSIs切口感染组(i SSIs)和器官/腔隙感染组(o/sSSIs)。采用单变量分析和多元Logistic回归分析评价患者发生SSIs的危险因素。结果术前血清白蛋白≤39.6 g/L [RR=2.631,95%CI (1.340,5.457),P=0.014]以及术前BMI≥23.9 kg/m2 [RR=2.081,95%CI (1.162,3.726),P=0.018]为发生i SSIs的独立危险因素。肿瘤位于直肠[RR=6.798,95%CI(3.087,20.450),P<0.01]、术前血清白蛋白≤32.5 g/L [RR=7.596,95%CI (2.761,24.470),P=0.002]、年龄≤56岁[RR=2.353,95%CI(1.942,2.851),P=0.040]以及男性[RR=2.413,95%CI(1.173,5.014),P=0.046]为o/sSSIs发生的独立危险因素。低血清白蛋白高BMI患者有较高的i SSIs发生率(32.3%),直肠癌血清白蛋白低患者有较高的o/sSSIs发生率(43.8%)。结论结直肠癌切除术患者的术前营养状况是患者术后发生SSIs的危险因素,对患者进行合理的术前管理可能降低发生SSIs的风险。

Objective To evaluate the related factors of surgical site infections(SSIs)in patients with colorectal cancer resection.Methods The clinical data of 396 patients with colorectal cancer resection were treated with incision infection(iSSIs)and organ/space SSIs(o/sSSIs).The clinical data of 396 patients with colorectal cancer resection were selected for surgical treatment in our hospital.The patients were divided into incisional SSIsgroup(iSSIs)and organ/space SSIs group(o/sSSIs).Univariate analysis and multivariate logistic regression analysis were used to evaluate the risk factors for SSIs in patients.Results Preoperative serum albumin≤39.6 g/L[RR=2.631,95%CI(1.340,5.457),P=0.014]and preoperative BMI≥23.9 kg/m^2[RR=2.081,95%CI(1.162,3.726),P=0.018]was an independent risk factor for iSSIs.The tumor located in the rectum[RR=6.798,95%CI:3.087~20.450,P<0.01],Preoperative serum albumin≤32.5 g/L[RR=7.596,95%CI(2.761,24.470),P=0.002],Age≤56 years[RR=2.353,95%CI(1.942,2.851),P=0.040]and gender male[RR=2.413,95%CI(1.173,5.014),P=0.046]were independent risk factors for o/sSSIs.The patients with low serum albumin and high BMI had a higher incidence of iSSIs(32.3%),and the patients with rectal cancer and low serum albumin had a higher incidence of o/s SSIs(43.8%).Conclusion Preoperative nutritional status is a risk factor for postoperative SSIs in patients with colorectal cancer resection,and rational preoperative management may reduce the risk of SSIs.