胃癌根治术后手术切口感染的病原学特征及危险因素分析

Pathologic Characteristics and Risk Factors Analysis of Surgical Incision Infection after Radical Gastric Cancer

目的探讨胃癌根治术后手术切口感染的病原学特征及危险因素。方法回顾性分析2018年1月至2020年12月于我院行胃癌根治术的282例患者临床资料,术后根据手术切口感染情况分为感染组与未感染组。对所有感染组患者进行病原菌鉴定,另外统计两组临床资料,分析感染的病原学特征及危险因素。结果282例患者术后有25例发生手术切口感染,发生率为8.87%(25/282);25例手术切口感染经细菌培养共检出34株病原菌,其中革兰阴性菌20株(58.82%),革兰阳性菌12株(35.29%),真菌2株(5.88%);感染组手术时间≥3h、合并糖尿病、围术期输血占比高于未感染组,差异有统计学意义(P<0.05);两组性别、年龄、预防性应用抗菌药物时间对比,差异无统计学意义(P>0.05);Logistic回归分析手术时间≥3h、合并糖尿病、围术期输血是胃癌根治术后手术切口感染的独立危险因素(P<0.05且OR≥1)。结论胃癌根治术后手术切口感染发生率较高,革兰阴性菌为主要病原菌,手术时间≥3h、合并糖尿病、围术期输血是导致切口感染发生的独立危险因素,临床需予以高度重视。

Objective To explore the pathologic characteristics and risk factors of surgical incision infection after radical gastric cancer.Methods The clinical data of 282 patients with radical gastric cancer from January 2018 to December 2020 were divided into infected group and uninfected group according to the surgical incision infection.Pathogens were identified in all infected groups,and two other clinical data were counted to analyze the pathogen characteristics and risk factors of infection.Results 25 postoperative incision infection occurred in 282 patients,The incidence rate was 8.87%(25/282);A total of 34 pathogens were detected through bacterial culture,Of these,20 gram-negative bacteria(58.82%),Gram-positive bacteria are 12 strains(35.29%),2 strains of fungi(5.88%);Surgical time of≥3h,combined with diabetes and perioperative transfusion was higher than in the uninfected group,Differdifference are significant(P<0.05);Time comparison of sex,age and preventive antibiotics in the two groups,Differdifference have no statistical significance(P>0.05);Logistic regression analysis time≥3h,with diabetes,perioperative transfusion are independent risk factors for surgical incision infection after radical gastric cancer(P<0.05 and OR≥1).Conclusion The incidence rate of surgical incision infection after radical gastric cancer is high,and gram-negative bacteria are the main pathogen.≥3h,combined with diabetes and peripheral blood transfusion are independent risk factors for incision infection,which should pay great attention to in clinical practice.