外伤性肝破裂腹腔镜术后感染发生状况及其影响因素分析

Infection and Its Influencing Factors After Laparoscopic Surgery for Traumatic Liver Rupture

目的分析外伤性肝破裂腹腔镜术后感染发生状况,并分析其影响因素。方法本研究为回顾性分析,收集2019年2月至2022年2月在平煤神马医疗集团总医院接受腹腔镜下修补术治疗的118例外伤性肝破裂患者的临床资料,将术后7 d内发生感染的患者纳入发生组(30例),将术后7 d内未发生感染的患者纳入未发生组(88例)。统计患者临床资料,分析腹腔镜术后感染发生的影响因素。结果两组肝损伤分级、血清白蛋白、术中持续低血压时间比较,差异有统计学意义(P<0.05);两组受伤至入院时间、手术时间、术中出血量、白细胞计数等其他资料比较,差异无统计学意义(P>0.05)。logistic结果显示,肝损伤分级为Ⅲ级、术中持续低血压时间长是外伤性肝破裂腹腔镜术后感染发生的危险因素(OR>1,P<0.05),血清白蛋白水平高是保护因素(OR<1,P<0.05)。结论肝损伤分级、血清白蛋白、术中持续低血压时间是外伤性肝破裂腹腔镜术后发生感染的影响因素,医护人员及患者自身可进行针对性干预,减少感染发生的风险。

Objective To analyze the incidence of infection after laparoscopic surgery for traumatic liver rupture and its influencing factors.Methods This study was a retrospective analysis.The clinical data of 118 patients with traumatic liver rupture who underwent laparoscopic repair in Pingmei Shenma Group General Hospital from February 2019 to February 2022 were collected.The data of patients with infection within 7 days after operation were included in the occurrence group(30 cases),and the data of patients without infection within 1 month after operation were included in the non-occurrence group(88 cases).The clinical data of patients were analyzed in detail,and the influencing factors of infection after laparoscopic surgery were analyzed.Results There were statistical differences in liver injury grade,serum albumin and duration of hypotension between the two groups(P<0.05).There was no statistical difference between the two groups in comparison of time from injury to admission,operation time,intraoperative blood loss,white blood cell count and other data between two groups(P>0.05).Logistic regression analysis showed that the risk factors of infection after laparoscopic surgery for traumatic liver rupture were liver injury gradeⅢand long duration of hypotension(OR>1,P<0.05),and the protective factors were high serum albumin level(OR<1,P<0.05).Conclusion Liver injury grade,serum albumin and duration of hypotension during operation are the influencing factors of infection after laparoscopic surgery for traumatic liver rupture.Medical staff and patients themselves can carry out targeted intervention to reduce the risk of infection.