胃癌根治术后肺部感染的血清炎症指标、病原菌分布及危险因素

Serum inflammatory indexes,pathogen distribution and risk factors of pulmonary infection after radical gastrectomy of gastric cancer

目的:研究胃癌根治术后并发肺部感染患者血清炎症指标、病原菌分布状况及其危险因素,为临床提供指导。方法:选择2017年7月至2020年7月在六安市人民医院进行胃癌根治术治疗的胃癌患者为研究对象,其中感染患者45例,非感染患者55例。比较两组血清炎症指标、病原菌分布状况并分析感染的危险因素。结果:感染组的血清炎症指标,包括白细胞数量、中性细胞百分比及C-反应蛋白(C-reactive protein,CRP)显著高于未感染组,差异有统计学意义(P<0.05);45例肺部感染患者检验标本共培养出病源菌82株。其中革兰阴性菌占绝大部分,共38株;其次是真菌24株和革兰阳性菌20株;分别占46.34%、29.27%和24.39%;肺部感染的危险因素包括术前血红蛋白、置管时间、糖尿病史、吸烟史及营养风险。结论:胃癌患者胃癌根治术后有肺部感染的风险,感染患者血清炎症指标高,病原菌分布以革兰阴性菌感染为主,肺部感染的危险因素有术前血红蛋白、置管时间、糖尿病史、吸烟史及营养风险等。

Objective:To study the serum inflammatory indexes,distribution of pathogenic bacteria and risk factors of patients with pulmonary infection after radical gastrectomy for gastric cancer,and to provide clinical guidance.Methods:Patients with gastric cancer who underwent radical gastrectomy in our hospital from July 2017 to July 2020 were selected as the subjects of this study,including 45 infected patients and 55 non-infected patients.Serum inflammatory indexes,pathogen distribution and risk factors of infection were compared between the two groups.Results:The serum inflammatory indexes,including WBC count,neutrophils percentage and C-reactive protein value(CRP)in the infected group were significantly higher than those in the uninfected group,with statistical significance(P<0.05).A total of 82 strains of pathogenic bacteria were isolated from 45 patients with pulmonary infection.Gram-negative bacteria accounted for most of them,with 38 strains.Then there were 24 strains of fungi and 20 strains of gram-positive bacteria,accounting for 46.34%,29.27%and 24.39%,respectively.The risk factors of pulmonary infection include preoperative hemoglobin,catheterization time,history of diabetes mellitus,smoking history,and nutritional risk.Conclusion:Patients with gastric cancer are at risk of pulmonary infection after radical gastrectomy.Serum inflammatory indexes of infected patients are high,and Gram-negative bacteria are the main pathogen distribution.Risk factors for pulmonary infection include preoperative hemoglobin,catheter time,diabetes history,smoking history and nutritional risk,etc.