腹腔镜下阑尾切除术后切口感染的病原菌分布及危险因素分析

Distribution and risk factors of pathogenic bacteria in incision infection after laparoscopic appendectomy

目的研究急诊腹腔镜下阑尾切除患者术后切口感染及病原菌分布状况,分析危险因素。方法通过回顾性调查方式,对某医院急诊行腹腔镜下阑尾切除术的患者术后切口感染及感染病原菌分布情况进行调查,并分析危险因素。结果调查医院急诊行腹腔镜下阑尾切除术的673例患者中,发生切口感染48例,切口感染发生率为7.13%。从48例患者术后切口感染标本中,共培养出病原菌67株,其中革兰阴性菌占分离菌株总数的71.64%。多因素分析提示,年龄≥50岁、合并糖尿病、手术时间≥60 min、阑尾坏疽化脓或穿孔和中转开腹等因素是急诊行腹腔镜下阑尾切除患者术后切口感染的独立危险因素(P<0.05)。结论急诊腹腔镜下阑尾切除患者术后切口感染的发生和多种因素有关,革兰阴性菌是主要感染病原菌。

Objective To study the incision infection and pathogenic bacteria distribution in patients after emergency laparoscopic appendectomy,and to analyze the risk factors.Methods By means of retrospective investigation,the incision infection and the distribution of pathogenic bacteria after laparoscopic appendectomy in emergency patients of a hospital were investigated,and the risk factors were analyzed.Results A total of 673 patients who underwent laparoscopic appendectomy in emergency department of a hospital were investigated.Among them,48 cases had incision infection,and the incidence of incision infection was 7.13%.A total of 67 strains of pathogenic bacteria were cultured from 48 specimens of patients with postoperative incision infection,of which Gram-negative bacteria accounted for 71.64%of the total number of isolated strains.Multivariate analysis showed that age≥50 years old,diabetes mellitus,operation time≥60 min,appendix gangrene,pyorrhea or perforation,and conversion to laparotomy were the independent risk factors for postoperative incision infection after emergency laparoscopic appendectomy(P<0.05).Conclusion The occurrence of incision infection after emergency laparoscopic appendectomy is related to many factors.Gram-negative bacteria are the main pathogens of infection.