老年胆石症手术治疗术后腹腔感染多因素COX回归模型分析

Multivariate COX Regression Model Analysis of Postoperative Abdominal Infection in Elderly Cholelithiasis

目的:探讨老年胆石症手术治疗术后腹腔感染多因素COX回归模型。方法:选择笔者所在医院2018年1月-2020年10月收治的339例老年胆石症患者,所有患者均行手术治疗。采用单因素分析影响术后腹腔感染相关因素;采用多因素COX回归模型分析影响术后感染独立危险因素。结果:339例老年胆石症患者中,发生术后腹腔感染38例,感染率为11.21%;未发生腹腔感染301例,未感染率为88.79%。单因素分析显示,发生腹腔感染患者与未发生腹腔感染患者性别、体质指数、高血压和手术切口类型比较差异无统计学意义(P>0.05);发生腹腔感染患者与未发生腹腔感染患者年龄、糖尿病、手术时间、术中创伤性操作、留置引流管、住院时间和术后抗菌药物使用比较差异有统计学意义(P<0.05)。多因素COX回归模型显示,年龄>70岁、糖尿病、手术时间>2 h、术中创伤性操作、留置引流管、住院时间>10 d和术后抗菌药物使用>3种为影响术后腹腔感染危险因素。结论:老年胆石症手术治疗术后腹腔感染受多因素影响,其中年龄、糖尿病、手术时间、术中创伤性操作、留置引流管、住院时间和术后抗菌药物种类影响术后腹腔感染危险因素。

Objective:To explore the multivariate COX regression model of postoperative abdominal infection in elderly cholelithiasis.Method:A total of 339 elderly patients with cholelithiasis admitted in our hospital from January 2018 to October 2020 were selected,and all of them received surgical treatment.Univariate analysis was used to analyze the factors related to postoperative abdominal infection.Multivariate Cox regression model was used to analyze the independent risk factors for postoperative infection.Result:Among the 339 elderly patients with cholelithiasis,38 cases with postoperative abdominal infection,the infection rate was 11.21%.There were 301 cases without abdominal infection,and the rate of non-infection was 88.79%.Univariate analysis showed that there were no significant differences in gender,body mass index,hypertension and incision type between patients with abdominal infection and patients without abdominal infection (P>0.05).There were statistically significant differences in age,diabetes mellitus,operation time,intraoperative traumatic operation,indwelling drainage tube,hospitalization time and types of postoperative antibiotics between patients with abdominal infection and patients without abdominal infection (P<0.05).Multivariate COX regression model showed that age>70 years old,diabetes mellitus,operation time>2 h,intraoperative traumatic operation,indwelling drainage tube,hospitalization time>10 d and types of postoperative antibiotics>3 were the risk factors of postoperative abdominal infection.Conclusion:Postoperative abdominal infection in elderly patients with cholelithiasis is influenced by many factors,including age,diabetes mellitus,operation time,intraoperative traumatic operation,indwelling drainage tube,hospitalization time and types of postoperative antibiotics.