胃肠道手术后切口感染影响因素及病原菌分析

Analysis of influencing factors and infected bacteria of incision infection after gastrointestinal surgery

目的研究胃肠道手术后切口感染的影响因素、病原菌类型,指导临床工作,降低切口感染率。方法回顾分析2018年11月~2019年12月218例胃肠道手术患者的临床资料,对切口感染相关因素以及感染菌株进行分析。结果218例患者中发生切口感染的患者为17例,感染率为7.798%。切口感染因素的单因素分析中年龄≥60岁,术前白蛋白<35 g/L,合并糖尿病,手术时间≥3 h,肠道手术,开放手术与切口感染具有相关性(P<0.05)。性别,术前血红蛋白,手术类型及抗生素使用与切口感染未见明显相关性(P>0.05),革兰阳性菌感染率明显低于革兰阴性菌(23.53%vs.76.47%)。革兰阳性菌以葡萄球菌为主,革兰阴性菌以大肠杆菌为主。结论胃肠道手术后切口感染的发生率较高,这与多种因素有关,需要在围手术期加强监控,予以干预措施,以降低切口感染率。

Objective To study the influencing factors and bacterial types of incision infection after gastrointestinal surgery,to guide clinical work and reduce the infection rate of incision.Methods The clinical data of 218 patients undergoing gastrointestinal surgery from November 2018 to December 2019 were analyzed retrospectively,and the related factors of incision infection and infection strains were analyzed.Results Incision infection occurred in 17 of 218 patients,and the infection rate was 7.798%.In univariate analysis of incision infection factors,age≥60 years old,preoperative albumin<35 g/L,diabetes mellitus,operation time≥3 h,intestinal operation and open operation were correlated with incision infection(P<0.05).Gender,preoperative hemoglobin,operation type and antibiotic use had no obvious correlation with incision infection(P>0.05),and the infection rate of gram-positive bacteria was significantly lower than that of gram-negative bacteria(23.53%vs.76.47%)。Staphylococcus is the main gram-positive bacteria,and Escherichia coli is the main gram-negative bacteria.Conclusion The incidence of incision infection after gastrointestinal surgery is high,which is related to many factors.It is necessary to strengthen monitoring and intervention measures during perioperative period to reduce the infection rate of incision.