两种手术方式对胃癌手术患者术后医院感染的影响

Influence of two surgical approach on nosocomial infection in surgery patients with gastric cancer

目的探讨两种手术方式对胃癌手术患者术后医院感染的影响。方法选取2017年1月-2017年12月南阳医学高等专科学校第一附属医院行手术治疗的胃癌患者164例,根据患者实际所行手术方式分为开腹组(66例)与微创组(98例),两组均行标准的胃癌根治性D2切除术,开腹组采取开腹下手术,微创组采取腹腔镜下手术,观察患者术后医院感染发生情况,分析引起医院感染的影响因素。结果 164例患者术后共有26例发生医院感染,感染率为15.85%,其中开腹组、微创组感染率分别为25.76%、9.18%,开腹组感染率高于微创组(P<0.05)。Logistics回归分析结果显示年龄、吸烟史、病变分期、淋巴结清扫个数及术中出血量、手术方式是术后医院感染发生的独立影响因素(P<0.05)。结论手术方式对胃癌手术患者术后医院感染存在影响,年龄、吸烟史、病变分期、淋巴结清扫个数及术中出血量、手术方式是术后医院感染发生的主要影响因素。

OBJECTIVE To investigate the influence of surgical approach on nosocomial infection in surgery patients with gastric cancer. METHODS The total of 164 surgery patients with gastric cancer from January to December 2017 in the First Affiliated Hospital of Nanyang Medical College were recruited. The patients were divided into the open group(66 cases) and the minimally invasive group(98 cases) according to the actual operation mode. D2 radical operation of gastric cancer were performed in both groups, with open abdominal surgery of the open group and laparoscopic surgery of the minimally invasive group. To observe the occurrence of postoperative hospital infection and analyze the related risk factors of hospital infection. RESULTS The 26 cases patients of 164 cases were nosocomial infection, with the infection rate of 15.85%;the infection rate in the open group and the minimally invasive group were 25.76% and 9.18%, respectively. The differences between them were statistically significant(P=0.004).Multivariate logistic regression analysis showed that age, smoking history, pathological stage, number of lymph node dissection and intraoperative blood loss and surgical approach were the independent risk factors for postoperative nosocomial infection in patients with gastric cancer(P<0.05). CONCLUSION Surgical approach had effect on nosocomial infection in surgery patients with gastric cancer. Age, smoking history, pathological stage, number of lymph node dissection and intraoperative blood loss were the independent risk factors for postoperative nosocomial infection in patients with gastric cancer.