急性肠梗阻急诊术后切口感染的病原菌及危险因素分析

Analysis on Pathogenic Bacteria of Incision Infection after Emergency Operation for Acute Intestinal Obstruction and Risk Factors

目的:分析急性肠梗阻急诊术后切口感染的病原菌分布特点,以及影响切口感染的危险因素。方法:以2021年4月至2023年8月于我院急诊手术治疗的140例急性肠梗阻患者为研究对象,根据术后切口是否感染分为感染组和未感染组。感染组均取患者切口脓性分泌物进行病原菌检测,分析病原菌分布情况;应用单因素分析及Logistic回归分析法分析术后切口感染的相关危险因素。结果:140例急性肠梗阻急诊手术者中,术后切口感染27例(19.29%);病原菌检测共检出菌株36株,以大肠埃希菌、肺炎克雷伯菌为主。年龄≥60岁、BMI≥28 kg/m^(2)、合并糖尿病、夏季实施手术、手术时间≥120 min、Ⅲ类切口、血运性肠梗阻是导致急性肠梗阻急诊术后切口感染的独立危险因素,P<0.05。结论:急性肠梗阻急诊术后切口感染发生率较高,病原菌以大肠埃希菌、肺炎克雷伯菌为主,影响切口感染的危险因素很多,对于年龄大、肥胖、合并糖尿病、夏季实施手术、手术时间长、Ⅲ类切口、血运性肠梗阻者临床应积极予以干预。

Objective To analyze the pathogenic bacteria distribution of incision infection after emergen-cy operation for acute intestinal obstruction and risk factors affecting incision infection.Methods A total of 140 patients with acute intestinal obstruction who underwent emergency operation at our hospital from April 2021 to August 2023 were selected as the research objects.The patients were divided into the infec-tion group and the non-infection group according to whether the postoperative wound was infected.The pathogenic bacteria in the infection group were detected by taking the purulent secretions from the incision to analyze the distribution of pathogenic bacteria.The independent risk factors of postoperative incision in-fection were analyzed by using the single factor analysis and Logistic regression analysis.I Results A-mong 140 patients with acute intestinal obstruction who underwent emergency operation,27(19.29%)had postoperative incision infection.A total of 36 pathogenic strains were detected,mainly Escherichia coli and Klebsiella pneumoniae.The independent risk factors of postoperative incision infection in patients with acute intestinal obstruction after emergency operation were age≥60 years,body mass index(BMI)≥28 kg/m^(2),diabetes mellitus,summer operation,operation time≥120 min,class Il incision,and mesen-teric vascular obstruction,P<0.05.Conclusion The incidence of postoperative incision infection after emergency operation for acute intestinal obstruction is high,and the pathogenic bacteria are mainly Esche-richia coli and Klebsiella pneumoniae.There are many risk factors for postoperative incision infection,and clinically,patients with old age,obesity,diabetes,summer operation,long operation time,class II incision,and mesenteric vascular obstruction should be actively intervened.