乳腺癌术后皮瓣下积液伴感染的病原菌特征及相关因素分析

Analysis of Pathogenic Characteristics and Related Factors of Subcutaneous Effusion with Infection after Breast Cancer Surgery

目的:分析乳腺癌术后皮瓣下积液伴感染的病原菌特征及相关影响因素,为预防和治疗感染提供参考。方法:回顾性分析2014年3月至2019年12月1121例女性乳腺癌手术患者的临床病理资料,分析术后皮瓣下积液伴感染的病原菌特征及相关因素影响因素。结果:161例皮瓣下积液伴感染患者检出185株病原菌,其中革兰氏阳性菌120株(64.86%),革兰氏阴性菌65株(35.14%),金黄色葡萄球菌、大肠埃希菌为主要病原菌。经多因素Logistic回归分析显示,年龄≥60岁、BMI>24 kg/m^(2)、手术时间>2 h、带管时间>7 d和伴有基础疾病是导致术后皮瓣下积液伴感染的相关危险因素(P<0.05)。结论:乳腺癌术后皮瓣下积液伴感染的病原菌以革兰氏阳性菌为主,发生感染与多种因素有关,应及时的干预和处理相关危险因素,降低皮瓣下积液伴感染的发生率。

Objective To analyze the characteristics of pathogenic bacteria and related influencing factors of subcutaneous effusion with infection after breast cancer surgery,so as to provide reference for the prevention and treatment of infection.Methods The clinicopathological date of 1121 patients who underwent the breast cancer surgery in our department from March 2014 to December 2019 were retrospectively analyzed.The pathogenic bacteria characteristics and related factors of postoperative subcutaneous effusion with infection were analyzed.Results 185 strains of pathogenic bacteria were detected in 161 patients with subcutaneous effusion and infection,including 120(64.86%)strains of gram-positive bacteria and 65(35.14%)strains of gram-negative bacteria.Staphylococcus aureus and Escherichia coli were the main pathogenic bacteria.Multivariate logistic regression analysis showed that age≥60 years old,body mass index>24 kg/m^(2),operation time>2 hours,the time of drainage>7 days and underlying diseases were the related risk factors for postoperative subcutaneous effusion with infection(P<0.05).Conclusion Gram-positive bacteria are the main pathogens of subcutaneous effusion with infection after breast cancer surgery.The occurrence of infection is related to a variety of factors.Timely intervention and treatment of relevant risk factors should be carried out to reduce the incidence of infection in the subcutaneous effusion.