摘要
目的外科手术术后感染一直是临床需要解决的问题,危险因素复杂多样。本研究分析胃肠外科患者术后感染危险因素。方法选取2018-07-01-2019-07-01大连市中心医院胃肠外一科收治的实施胃肠手术的患者为研究对象,根据有无术后感染选取感染组(n=56)和对照组(n=222),收集研究对象临床资料,包括年龄、性别、手术时间、是否患有糖尿病及是否使用呼吸机等,分析各种因素对发生术后感染影响,并分析术后感染患者病原菌分离结果。结果56例术后感染患者中共分离出72株病原菌,以革兰氏阴性菌为主,共52株,占72.2%。单因素分析结果显示:年龄>60岁(χ^2=24.071,P<0.001)、体质量指数≤35kg/m2(χ^2=25.794,P<0.001)、切口类型Ⅱ和Ⅲ型(χ^2=65.173,P<0.001)、手术时间>2h(χ^2=4.759,P=0.033)、住院时间>30d(χ^2=30.009,P<0.001)、手术季节为夏季(χ^2=13.829,P<0.001)、合并糖尿病(χ^2=29.383,P<0.001)、使用呼吸机(χ^2=8.912,P<0.001)和预防用药(χ^2=22.659,P<0.001)均与胃肠外科手术术后感染有关联。多因素Logistic回归分析结果显示,年龄>60岁(OR=2.758,95%CI为1.465~5.193,P<0.001)、患有糖尿病(OR=2.164,95%CI为1.075~4.355,P=0.032)、住院时间长(OR=0.433,95%CI为0.225~0.831,P=0.012)、手术时间长(OR=0.249,95%CI为0.078~0.801,P=0.020)、未预防用药(OR=0.378,95%CI为0.153~0.934,P=0.035)为感染发生危险因素。结论年龄>60岁、患有糖尿病、住院时间长、手术时间长、未预防用药的胃肠外科手术患者更容易发生术后感染。
OBJECTIVE Infection after surgical operation has always been a clinical problem to be solved,and the risk factors are complex and diverse.This study analyzes the risk factors of infection in patients after gastrointestinal surgery.METHODS The patients who underwent gastrointestinal surgery in the Department of Gastroenterology of Dalian City Central Hospital from July 1,2018 to July 07,2018 were selected as the research subjects,and the infection group(n=56)and the control group(n=222)were selected according to the presence or absence of postoperative infection,collecting the clinical data of the research subjects,including age,gender,operation time,whether they have diabetes and whether they use ventilator.To analyze the influence of various factors on the occurrence of postoperative infection,and the isolation of pathogens in patients with postoperative infection.RESULTS A total of 72 pathogenic bacteria were isolated from 56 patients with postoperative infection,mainly Gram-negative bacteria,52 strains(72.2%).Univariate analysis showed that age>60 years(χ^2=24.071,P<0.001),body mass index≤35 kg/m2(χ^2=25.794,P<0.001),incision typesⅡandⅢ(χ^2=65.173,P<0.001),operation time>2 h(χ^2=4.759,P=0.033),hospitalization time>30 d(χ^2=30.009,P<0.001),operation season was summer(χ^2=13.829,P<0.001),combined diabetes(χ^2=29.383,P<0.001),use of ventilator(χ^2=8.912,P<0.001)and preventive medication(χ^2=22.659,P<0.001)were all associated with infections after gastrointestinal surgery.Multivariate logistic regression analysis showed that age>60 years(OR=2.758,95%CI:1.465-5.193,P<0.001),diabetes(OR=2.164,95%CI:1.075-4.355,P=0.032),long hospital stay(OR=0.433,95%CI:0.225-0.831,P=0.012),long operation time(OR=0.249,95%CI:0.078-0.801,P=0.020)and unprevented medication(OR=0.378,95%CI:0.153-0.934,P=0.035)were independent risk factors for infection.CONCLUSION Patients with gastrointestinal surgery who were older than 60 years of age,had diabetes,had a long hospital stay,had a long operation time,and had no preventive medication were more likely to have postoperative infection.
作者
李胜杰
王玉杰
LI Sheng-Jie;WANG Yu-jie(Department of Gastrointestinal Surgery,Dalian Central Hospital,Dalian116000,P.R.China)
出处
《社区医学杂志》
2020年第10期759-762,共4页
Journal Of Community Medicine
关键词
胃肠外科手术
术后感染
糖尿病
住院时间
手术时间
预防用药
gastrointestinal surgery
postoperative infection
diabetes
length of hospitalization
operation time
preventive medication
作者简介
通信作者:李胜杰,男,辽宁大连人,硕士,主治医师,主要从事胃肠道疾病的外科治疗研究工作。Tel:86-411-8442001,E-mail:lishengjie_jiayou@aliyun.com
