结直肠癌手术患者术后切口感染病原菌及危险因素调查分析

Pathogenic Bacteria and Risk Factors of Postoperative Incision Infection in Patients with Colorectal Cancer

目的调查分析结直肠癌手术患者术后切口感染的病原菌及危险因素。方法回顾性分析我院2018年5月-2019年11月经手术治疗的93例结直肠癌患者的临床资料,结合患者术后切口感染情况、病原菌分布、药敏试验结果,分析患者术后切口感染的危险因素。结果结直肠癌手术患者术后切口感染的发生率为21.51%。细菌耐药性较高的药物:金黄色葡萄球菌为庆大霉素(83.33%)、头孢曲松(66.67%);表皮葡萄球菌为庆大霉素(100.00%)、头孢曲松(75.00%)、左氧氟沙星(75.00%);大肠埃希菌为氨苄西林(87.50%)、头孢他啶(75.00%)、环丙沙星(50.00%);阴沟肠杆菌为环丙沙星(100.00%)、左氧氟沙星(100.00%)、头孢他啶(75.00%)。患者年龄大、体重指数高、合并有糖尿病、临床分期为Ⅲ~Ⅳ期、开腹手术、手术时间过长均为结直肠癌术后发生切口感染的独立危险因素(P<0.05)。结论根据结肠癌术后患者切口的病原菌分布、耐药性及影响切口感染的独立危险因素;及时采用相关手段进行干预,可降低发生术后切口感染的概率,改善预后。

Objective To investigate and analyze the pathogenic bacteria and risk factors of postoperative incision infection in patients with colorectal cancer(CRC).Methods The clinical data of 93 patients with CRC undergoing surgery in our hospital from May 2018 to November 2019 were retrospectively analyzed.Based on the patient's postoperative incision infection,pathogen distribution,and results of drug sensitivity test,the risk factors of postoperative incision infection were analyzed.Results The incidence of postoperative incisional infections in patients with CRC was 21.51%.Staphylococcus aureus had higher resistance to Gentamicin(83.33%)and Ceftriaxone(66.67%).Surface staphylococcus had higher resistance to Gentamicin(100.00%),Ceftriaxone(75.00%)and Levofloxacin(75.00%).Escherichia coli had higher resistance to Ampicillin(87.50%),Ceftazidime(75.00%),and Ciprofloxacin(50.00%).Enterobacter cloacae had higher resistance to Ciprofloxacin(100.00%)and Levofloxacin(100.00%),and Ceftazidime(75.00%).Older age,higher BMI index,combination with diabetes,clinical stageⅢ-Ⅳ,laparotomy,and longer duration of operation were all independent risk factors for postoperative incision infection in patients with CRC(P<0.05).Conclusion According to the distribution of pathogenic bacteria,drug resistance and independent risk factors affecting incision infection in patients undergoing surgery for CRC,timely intervention with relevant methods can reduce the probability of incision infection after surgery and improve the prognosis of patients.