结肠癌手术切口感染的相关因素分析

Analysis of the Factors Associated with Colon Cancer Surgical Indentation Infection

摘要: 目的：手术切口感染是外科病人常见的医院感染之一。其不仅给患者带来巨大的疼痛，增加患者的住院时间，加重患者的经济负担，还会严重影响患者的预后。本研究通过回顾性分析青岛大学医学院附属医院急诊普外科2017年l月到2019年12月期间的320例结肠癌手术患者的临床资料，探讨术后切口感染相关的影响因素，为降低切口感染的发生率提供依据。方法：根据患者术后是否发生切口感染，将其分为感染组和非感染组。同时，统计患者的基线情况、手术相关因素及临床结局等资料，分析感染组细菌培养的结果与相关的影响因素。结果：手术后切口感染25例，切口感染率7.81%。手术后切口感染与肥胖、糖尿病及术前长期吸烟有关；与性别、年龄、术前是否应用抗生素、急症手术、手术时间、切口长度及肿瘤分期无显著相关性。结论：结肠癌患者术后切口感染发生率高，病原菌以革兰阴性菌(大肠埃希菌)为主，BMI ≥ 25 kg/m²、合并糖尿病与吸烟是术后切口感染发生的独立危险因素。因此，临床依据结肠癌患者术后切口感染病原菌分布特点及影响因素，采取针对性、个体化的围术期干预措施，可切实降低术后切口感染的发生率，显著改善预后。

Abstract: Objective: Surgical incision infection is one of the common nosocomial infections in surgical patients. It not only brings great pain to patients, increases the length of hospital stay, increases the economic burden of patients, and seriously affects the prognosis of patients. This study retrospectively analyzed the clinical data of 320 patients undergoing colon cancer surgery from January 2017 to December 2019 in the Department of Emergency General Surgery, Affiliated Hospital of Qingdao University Medical College to explore the influencing factors of postoperative incision infection and provide the basis for reducing the incidence of incision infection. Methods: The patients were di-vided into infection group and non-infection group according to whether incision infection occurred after operation. At the same time, the baseline conditions, surgery-related factors and clinical outcomes of the patients were statistically analyzed, and the results of bacterial culture in the infection group and related influencing factors were analyzed. Results: There were 25 cases of postoperative incision infection, and the incision infection rate was 7.81%. Postoperative incision infection was associated with obesity, diabetes and preoperative long-term smoking; there was no significant correlation with gender, age, preoperative use of antibiotics, emergency surgery, operation time, incision length and tumor stage. Conclusion: The incidence of postoperative incision infection in patients with colon cancer is high. The main pathogen is negative bacteria (large intestine). BMI ≥ 25 kg/m², diabetes and smoking are independent risk factors of postoperative incision infection. Therefore, according to the distribution characteristics and influencing factors of pathogens of postoperative incision infection in patients with colon cancer, targeted and individualized intervention measures can effectively reduce the incidence of postoperative incision infection and significantly improve the prognosis.