结直肠手术部位感染危险因素分析

Risk Factors of Surgery Site Infection After Colorectal Surgery

目的探索结直肠手术部位发生感染的危险因素,为预防结直肠手术部位的感染提供预防措施。方法回顾性调查川北医学院附属医院2014-07/2018-07的结直肠手术患者,收集患者基本情况、感染相关因素、感染情况、病原菌分布情况,采用SPSS 18.0软件分析,Logistic回归探索结直肠手术部位发生感染的危险因素,检验水准α=0.05。结果 396例结直肠手术患者中,手术部位感染37例,感染率为9.34%,其中左半结肠的感染率最高;共分离出病原菌株48例,其中革兰阳性菌株11株,革兰阴性菌株37例。Logistic回归分析显示患有糖尿病(OR=1.99,95%CI:1.01-3.96)、手术类型为急诊(OR=2.69,95%CI:1.18-6.13)、手术持续时间≥180 min(OR=3.29,95%CI:1.62-6.66)、切口等级为Ⅲ、Ⅳ(OR=2.61,95%CI:1.15-5.95),术后抗菌药物使用时间<7 d(OR=6.11,95%CI:2.04-18.31)是结直肠手术部位发生感染的独立危险因素(P<0.05)。结论川北医学院附属医院结直肠手术部位发生感染的危险因素较多,应制定针对性的干预措施,从而降低结直肠手术发生感染的风险。

Objective To investigate the risk factors of surgery site infection(SSI) after colorectal surgery in order to provide the prevention evidence of SSI. Methods The patients undergoing colorectal surgery in the affiliated Hospital of North Sichuan Medical College from July 2014 to July2018 were investigated retrospectively. The basic information, risk factors of SSI, infection sites and the distribution of pathogenic bacteria were collected. Logistic regression analysis was used to analyze the risk factors of SSI after colorectal surgery by using SPSS 18.0 software with α=0.05.Results A total of 396 patients were included. 37 cases of SSI was found in this study with the infection rate of 9.34%. The infection rate was the highest in the left colon. 48 cases of pathogenic strains were isolated;11 strains were Gram positive and 37 strains were Gram negative.Diabetes mellitus(OR=1.99,95%CI:1.01-3.96),emergency operation(OR=2.69, 95% CI: 1.18-6.13), the duration of operation ≥180 min(OR=3.29, 95% CI: 1.62-6.66), the incision grade of III,IV(OR=2.61,95%CI:1.15-5.95) and the postoperative antibiotic time <7 days(OR=6.11,95% CI: 2.04-18.31) were independent risk factors for SSI under colorectal surgery by using Logistic regression analysis. Conclusion There are many risk factors for SSI under colorectal surgery in the affiliated Hospital of North Sichuan Medical College. Intervention measures should be actively taken to reduce the incidence of SSI after colorectal surgery.