左半结肠癌术后手术部位感染统计及危险因素分析

Investigation on postoperative surgical site infection and risk factors for underwent left-sided colon radical operation

目的对左半结肠癌手术部位感染(SSI)的状况进行统计,并对主要相关危险因素进行分析,以协助指导临床实施相关预防或干预措施。方法回顾性分析2015年1月-2019年12月于吉林大学第一医院胃肠外科行左半结肠癌根治术的332例患者病例资料,其中男205例,女117例,年龄范围18~80岁,统计术后SSI的发生情况及相关临床资料,对影响SSI的因素进行单因素及多因素logistic回归分析。结果共纳入左半结肠癌手术病例322例,其中发生手术部位切口感染79例,总SSI发病率24.5%,其中发生浅部感染的56例,发生深部感染的23例。单因素分析筛选出SSI发生的危险因素:合并糖尿病,术前血清白蛋白<35 g/L、体重指数≥24 kg/m^2、ASA≥3分、手术时间≥120 min、吻合口瘘、住院天数≥10 d、住院费用、抗生素使用时间≥6 d,以上因素差异均具有统计学意义(P<0.05)。多因素分析结果提示:术前血清白蛋白<35 g/L、体重指数≥24 kg/m^2、ASA≥3分、手术时间≥120 min为SSI的独立危险因素(P<0.05)。结论左半结肠癌根治术术后发生SSI与多种因素相关,患者术前体重指数≥24 kg/m^2、血清白蛋白<35 g/L、ASA等级较高、手术时间长为SSI的高危人群,应有针对性的加强实施相关预防或干预措施。

Objective To investigate the characteristics and related risk factors for postoperative surgical site infection(SSI)for patients of left-sided colon radical operation,so as to guide clinical intervention measures.Methods Three hundred and twenty-two patients who underwent left-sided colon radical operation between January 2015 and December 2019 were surveyed retrospectively in the Department of Gastrointestinal and Anal Surgery,Jilin university First Hospital,including 205 male,and 117 female,aged from 18 to 80 years old.The clinical data for each patient were collected and analyzed.The influencing factors and possible risk factors were conducted by single factor analysis and Logistic analysis.Results Among 332 patients,79 patients developed SSI,total SSI rate was 24.5%,among which 56 cases of superficial incision infection and 23 cases of organ/lacunar infection.Single factor analysis showed that hypoalbuminema(<35 g/L),BMI≥24 kg/m^2,ASA≥3,operation time≥120 min,hospitalization time≥10 d,diabetes,hospitalization expenses,anastomotic leakage were high risk factors for SSI.Logistic analysis showed the risk factors for SSI infection were diabetes,ASA≥3,operation time≥120 min,hypoalbuminema(<35 g/L).Conclusions The occurrence of SSI was related to multiple factors.The patients with hypoalbuminema(<35 g/L),BMI≥24 kg/m^2,ASA≥3,operation time≥120 min were high-risk factors for SSI.The implementation of relevant prevention or intervention measures should be intensified.