胰十二指肠切除术后腹腔感染的病原菌构成及危险因素分析

The composition of pathogenic bacteria and analysis of risk factor in patients with abdominal infection after pancreaticoduodenectomy

目的探讨我院胆胰外科胰十二指肠切除术后腹腔感染患者的病原菌构成及危险因素,以期进行总结。方法选取2015年1月~2020年12月我院胆胰外科行胰十二指肠切除术的109例患者做回顾性分析,并对术后腹腔感染的病原菌分布和相关危险因素等资料进行统计学分析。结果在109例患者中,共出现感染27例,感染率为24.77%,共检出病原体42株,革兰阳性菌12株,占比28.57%,革兰阴性菌28株,占比66.67%,真菌2株,占比4.76%。单因素分析结果显示术后腹腔出血和胰瘘能显著影响患者术后腹腔感染的发生率(P<0.05);二元logistic回归分析结果显示术后腹腔出血和胰瘘是胰十二指肠术后腹腔感染的独立危险因素。结论胰十二指肠术后腹腔感染发生率高,应从术前、术中、术后多方面、个体化综合考虑,加强对手术患者的管理,以降低感染率。

Objective To explore the composition of pathogenic bacteria and risk factors in patients with abdominal infection after pancreaticoduodenectomy(PD)in department of biliary and pancreatic surgery.Methods The clinical data of 109 patients who underwent PD from January 2015 to December 2020 were retrospectively analyzed.The distribution of postoperative infection pathogens and related risk factors were used for statistical analysis.Results In 109 patients,27 cases were infected,with an infection rate of 24.77%.A total of 42 pathogens were detected,including 12 gram-positive bacteria,accounting for 28.57%,28 gram-negative bacteria,accounting for 66.67%,and 2 fungi,accounting for 4.76%.Univariate analysis showed that postoperative abdominal hemorrhage and pancreatic fistula could significantly affect the incidence of abdominal infection after PD(P<0.05).Binary logistic regression analysis showed that postoperative abdominal hemorrhage and pancreatic fistula were independent risk factors for abdominal infection after PD.Conclusions The incidence of abdominal infection after PD is relatively high,and the management of surgical patients should be strengthened from an individualized and comprehensive perspective to ultimately reduce the infection rate.