血糖水平与肺癌根治术手术部位感染的相关关系及术后抗生素治疗效果

Correlation between blood glucose level and surgical site infection in radical lung cancer surgery and the effect of postoperative antibiotic treatment

目的探讨与分析血糖水平与肺癌根治术手术部位感染的相关关系及术后抗生素治疗,为临床上预防手术部位感染提供参考。方法选择2017年5月至2021年4月在岐山县医院进行择期肺癌根治术的患者300例作为研究对象,观察与记录患者术后1~14 d手术部位感染发生情况,调查患者血糖、临床资料并进行相关分析,并分析感染患者抗生素治疗后效果。结果在300例患者中,术后14 d发生手术部位感染35例(感染组),占比11.6%,其中切口感染25例,胸膜腔感染4例,肺部感染6例。感染组的性别、体质量指数、术中出血量、引流管放置时间等与非感染组对比差异无统计学意义(P>0.05),2组切口愈合、手术时间、年龄、住院时间等对比差异有统计学意义(P<0.05)。感染组术前1 d的空腹血糖高于非感染组(P<0.05)。Pearson相关分析显示肺癌根治术患者的血糖、切口愈合、手术时间、年龄、住院时间与手术部位感染存在相关关系(P<0.05)。二分类Logistic回归分析显示血糖、切口愈合、手术时间、年龄、住院时间为导致患者术后部位感染发生的重要因素(P<0.05)。35例感染患者经过抗生素治疗后,血常规恢复正常时间为(12.23±0.21)d,住院时间为(14.3±1.4)d,体温恢复正常时间为(8.2±0.4)d。结论肺癌根治术手术部位感染比较常见,术前血糖水平为导致手术部位感染的重要因素,术前进行血糖控制具有重要价值,且抗生素治疗具有较好效果。

Objective To investigate and analyze the correlation between blood glucose level and surgi-cal site infection in radical lung cancer surgery and postoperative antibiotic treatment,to provide a reference for the active prevention of surgical site infection in clinical practice.Methods A total of 300 patients who under-went elective radical lung cancer surgery in Qishan County Hospital from May 2017 to April 2021 were selected as the study object,the occurrence of surgical site infections in patients was observed and recorded from 1d to 14 d after surgery,the patients′blood glucose,clinical data were investigeted,and carried out correlation analysis,and ana-lyzed the effect of the infected patients′post-treatment.Results Among the 300 patients,35 cases of sur-gical site infections(infection group)occurred in 14 d postoperatively,accounting for 11.6%,including 25 cases of incision infections,4 cases of pleural cavity infections,and 6 cases of lung infections.There was no statistically significant difference between the gender,body mass index,intraoperative bleeding,and drain placement time of the infection group compared with the non-infection group(P>0.05),and there was a statistically significant differ-ence between the two groups in terms of incision healing,operation time,age,and hospitalization time(P<0.05).The fasting blood glucose in the infected group was higher than that in the non-infected group 1 d before surgery(P<0.05).Pearson correlation analysis showed that there was a correlation between blood glucose,incision healing,operation time,age,hospitalization time and surgical site infection in patients undergoing radical lung cancer surgery(P<0.05).Binary logistic regression analysis showed that blood glucose,incision healing,operation time,age,and hos-pitalization time were important factors leading to the occurrence of postoperative site infections in patients(P<0.05).After symptomatic antibiotic treatment in 35 patients with infections,the time for blood counts to return to normal was(12.23±0.21)d,the hospitalization time was(14.3±1.4)d,and the time for the body tem-perature to re-turn to normal was(8.2±0.4)d.Conclusion Lung cancer radical surgery,surgical site infection is relatively common, preoperative blood glucose level is an important factor leading to surgical site infection, preop-erative blood glucose control is of great value, and impedance biotherapy has a better effect.