结直肠癌患者术后切口感染情况及其相关影响因素分析

An analysis on the postoperative incision infection and its related influencing factors in patients with colorectal cancer

目的探讨结直肠癌患者术后切口感染情况及其相关影响因素。方法选取200例结直肠癌患者,根据患者术后是否发生切口感染分为感染组(n=15)与未感染组(n=185)。统计结直肠癌患者术后切口感染情况及病原菌分布情况,比较感染组和未感染组的一般资料,并予以多因素Logistic回归分析法分析结直肠癌患者术后发生切口感染的危险因素。结果本研究中结直肠癌患者术后发生切口感染发生率为7.50%(15/200)。结直肠癌术后切口感染患者共分离出40株病原菌,其中31株革兰阴性菌(77.50%),以大肠埃希菌为主(57.50%);9株革兰阳性菌(22.50%),以金黄色葡萄球菌为主(15.00%)。多因素Logistic分析结果显示,合并糖尿病、营养不良及中性粒细胞/淋巴细胞比值(NLR)水平过高是结直肠癌患者术后发生切口感染的危险因素(OR=1.505,1.619,1.426,P<0.05)。结论结直肠癌患者术后切口感染的病原菌以革兰阴性菌为主,其中以大肠埃希菌占比最多,且结直肠癌患者术后发生切口感染的危险因素与患者合并糖尿病、营养不良及NLR水平过高等密切相关,临床可据此予结直肠癌患者针对性治疗及干预措施,预防结直肠癌患者术后发生切口感染。

Objective To investigate the postoperative incision infection and its related influencing factors in patients with colorectal cancer.Methods A total of 200 patients with colorectal cancer were selected and divided into an infected group(n=15)and a non-infected group(n=185)according to whether they had incision infection or not after surgery.The postoperative incision infection and the distribution of pathogens were counted,the general data of the infected group and the uninfected group were compared,and the risk factors of the postoperative incision infection were analyzed by a multivariate Logistic regression analysis.Results In this study,the incidence of the postoperative incision infection in patients with colorectal cancer was 7.50%(15/200).A total of 40 pathogenic bacteria were isolated from the patients,of which 31 strains were gramnegative bacteria(77.50%),mainly escherichia coli(57.50%),and 9 strains were gram-positive bacteria(22.50%),mainly staphylococcus aureus(15.00%).The multivariate logistic analysis results showed that the complication with diabetes,malnutrition,and high neutrophil/lymphocyte ratio(NLR)level were the risk factors for the postoperative incision infection in patients with colorectal cancer(OR=1.505,1.619,1.426,P<0.05).Conclusion The gram-negative bacteria are the main pathogens causing the postoperative incision infection in colorectal cancer patients,of which escherichia coli accounts for the largest proportion.The risk factors for the postoperative incision infection are closely related to the complication with diabetes mellitus,malnutrition and the high NLR level.Clinically,targeted treatment and intervention measures can be given to patients with colorectal cancer to prevent the postoperative incision infections.