腹部手术部位感染因素及预防措施研究进展
Research on Factors and Preventive Measures of Abdominal Surgical Site Infection
DOI: 10.12677/ACM.2023.132293, PDF,   
作者: 张 金, 段降龙*:陕西省人民医院普外二科,陕西 西安
关键词: 手术部位感染肥胖糖尿病吸烟预防措施Surgical Site Infection Obesity Diabetes Smoke Preventive Measure
摘要: 手术部位感染(Surgical site infection, SSI)是一种严重的手术并发症,约2%的手术会发生,总体占医学相关感染的20%。腹部脏器是较为庞大的一部分,近年来,随着医学诊疗技术的提高,腹部疾病诊断精准率不断地增加,手术也逐渐增多,SSI成为最常见的并发症。但是对其确切的因素至今未有明确的结论,大体而言多种不同的因素包括患者个人因素及手术操作等均会导致SSI的发生。现为降低腹部SSI,临床医生应该个体化多因素考虑及多学科会诊做好术前评估,规范操作,严格按照指南进行诊治,掌握防控措施,能有效减少SSI的发生,有利于患者预后。本文将腹部SSI相关因素及预防措施做一综述。
Abstract: Surgical site infection (SSI) is a serious surgical complication, occurring in approximately 2% of surgeries and accounting for approximately 20% of medically related infections. Abdominal organs are a relatively large part. In recent years, with the improvement of medical diagnosis and treat-ment technology, the accuracy of diagnosis of abdominal diseases has continued to increase, and the number of operations has gradually increased. SSI has become the most common complication. However, there is no clear conclusion about its exact factors. Generally speaking, both patient’s personal factors and surgical operations can lead to the occurrence of SSI. In order to reduce ab-dominal SSI, clinicians should consider multiple factors individually and conduct multidisciplinary consultation to complete preoperative evaluation and treatment in strict accordance with guide-lines, and master prevention and control measures, which can effectively reduce the occurrence of SSI and benefit the prognosis of patients. This article reviews the related factors and preventive measures of abdominal SSI.
文章引用:张金, 段降龙. 腹部手术部位感染因素及预防措施研究进展[J]. 临床医学进展, 2023, 13(2): 2103-2108. https://doi.org/10.12677/ACM.2023.132293

参考文献

[1] 王颖颖, 王古岩, 李军, 王雷, 程灏. 术后手术部位感染的影响因素及预防措施[J]. 中华麻醉学杂志, 2021, 41(2): 142-148.
[2] Li, P.-Y., Yang, D., Liu, D., Sun, S.-J. and Zhang, L.-Y. (2017) Reducing Surgical Site Infection with Negative-Pressure Wound Therapy after Open Abdominal Surgery: A Prospective Randomized Controlled Study. Scan-dinavian Journal of Surgery, 106, 189-195. [Google Scholar] [CrossRef] [PubMed]
[3] McLean, K.A., Mountain, K.E., Shaw, C.A., et al. (2021) Remote Diagnosis of Surgical-Site Infection Using a Mobile Digital Interven-tion: A Randomised Controlled Trial in Emergency Surgery Patients. NPJ Digital Medicine, 4, Article No. 160. [Google Scholar] [CrossRef] [PubMed]
[4] Wang, Z., Chen, J., Wang, P., et al. (2019) Surgical Site Infec-tion after Gastrointestinal Surgery in China: A Multicenter Prospective Study. Journal of Surgical Research, 240, 206-218. [Google Scholar] [CrossRef] [PubMed]
[5] de Lissovoy, G., Fraeman, K., Hutchins, V., Murphy, D,. Song, D. and Vaughn, B.B. (2009) Surgical Site Infection: Incidence and Impact on Hospital Utilization and Treatment Costs. American Journal of Infection Control, 37, 387-397. [Google Scholar] [CrossRef] [PubMed]
[6] Endo, S., Tsujinaka, T., Fujitani, K., et al. (2016) Risk Factors for Superficial Incisional Surgical Site Infection after Gastrectomy: Analysis of Patients Enrolled in a Prospective Random-ized Trial Comparing Skin Closure Methods. Gastric Cancer, 19, 639-644. [Google Scholar] [CrossRef] [PubMed]
[7] 林佩贤, 黄宝添, 王清江, 江静静, 林伟青. 腹部手术部位感染危险因素的病例对照研究[J]. 中华疾病控制杂志, 2015, 19(11): 1145-1148.
[8] 杨小兰, 胡增军, 马淑霞, 曾永杰. 中老年腹部手术切口感染的病原菌分布及耐药性分析[J]. 中国卫生检验杂志, 2021, 31(4): 434-437.
[9] Wojcik, B.M., Han, K., Peponis, T., Velmahos, G. and Kaafarani, H.M.A. (2019) Impact of In-tra-Operative Adverse Events on the Risk of Surgical Site Infection in Abdominal Surgery. Surgical Infections, 20, 174-183. [Google Scholar] [CrossRef] [PubMed]
[10] GlobalSurg Collaborative (2017) Determining the Worldwide Epidemi-ology of Surgical Site Infections after Gastrointestinal Resection Surgery: Protocol for a Multicentre, International, Pro-spective Cohort Study (GlobalSurg 2). BMJ Open, 7, e012150. [Google Scholar] [CrossRef] [PubMed]
[11] 刘琳, 等. 人体成分分析在体重管理单纯肥胖患者中的应用效果[J]. 中国当代医药, 2017, 24(18): 31-33.
[12] Thapa, B., Sutanto, E. and Bhandari, R. (2021) Thickness of Subcutaneous Fat Is a Risk Factor for Inci-sional Surgical Site Infection in Acute Appendicitis Surgery: A Prospective Study. BMC Surgery, 21, Article No. 6. [Google Scholar] [CrossRef] [PubMed]
[13] 李干斌, 王振军, 韩加刚. 用于肥胖及其相关代谢代谢性疾病的主要减重代谢手术方式发展现状[J]. 中华外科杂志, 2022(2): 188-192.
[14] Kimball, A., Schaller, M., Joshi, A., et al. (2018) Ly6CHi Blood Monocyte/Macrophage Drive Chronic Inflammation and Impair Wound Healing in Dia-betes Mellitus. Arteriosclerosis, Thrombosis, and Vascular Biology, 38, 1102-1114. [Google Scholar] [CrossRef
[15] 毕雪梅, 刘淑梅, 殷慧, 等. 2型糖尿病合并慢性伤口感染患者血清S100A8和S100A9蛋白表达与创面愈合及患者预后的关系[J]. 中华医院感染学杂志, 2022, 32(1): 94-98.
[16] 刘金石, 闫慧博, 杨昌盛, 等. 后路腰椎内固定术后手术部位感染的危险因素分析[J]. 中国脊柱脊髓杂志, 2019, 29(11): 995-1000.
[17] 白博, 桑宏勋, 吴子祥, 等. 四肢骨折内固定术后手术部位感染危险因素[J]. 中国感染控制杂志, 2017, 16(4): 334-337.
[18] Akhavan, S., Nguyen, L.C., Chan, V., et al. (2017) Impact of Smoking Cessation Counseling Prior to Total Joint Arthroplasty. Orthopedics, 40, e323-e328. [Google Scholar] [CrossRef] [PubMed]
[19] Miele, L., Marrone, G., Lauritano, C., et al. (2017) Gut-Liver Axis and Microbiota in NAFLD: Insight Pathophysiology for Novel Therapeutic Target. Current Pharmaceutical Design, 19, 5314-5324. [Google Scholar] [CrossRef] [PubMed]
[20] 薛志刚. 免疫营养干预影响肠道微生态及胃肠肿瘤结局基础与临床初探[D]: [博士学位论文]. 北京: 北京协和医学院, 2020.
[21] Warren, D.K., Nickel, K.B., Wallace, A.E., et al. (2017) Risk Factors for Surgical Site Infection after Cholecystectomy. Open Forum Infectious Diseases, 4, Article ID: ofx036. [Google Scholar] [CrossRef] [PubMed]
[22] 周培萱. 手术室切口感染的危险因素及其预防护理效果研究[J]. 当代医学, 2021, 27(18): 181-184.
[23] 周学颖, 赵峰, 王萃, 周乐. 复合保温对降低老年患者手术部位感染的效果分析[J]. 中华医院感染学杂志, 2016, 26(5): 1113-1115.
[24] 张玲燕, 张玲玲, 李海英. 急诊腹腔镜手术患者切口感染的手术室相关危险因素及病原菌特点[J]. 中国消毒学杂志, 2021, 38(9): 667-669+673.
[25] 戴文斌. 内脏脂肪面积对腔镜结肠癌手术结局的影响及内脏肥胖患者的术式选择[D]: [硕士学位论文]. 福州: 福建医科大学, 2018.
[26] Cai, X., Shen, W., Guo, Z., et al. (2018) Thickness of Subcutaneous Fat Is a Predictive Factor of Incisional Surgical Site Infection in Crohn’s Disease Surgery: A Retrospective Study. Gastroenterology Research and Practice, 2018, Article ID: 1546075. [Google Scholar] [CrossRef] [PubMed]
[27] Witsø, E. (2012) The Role of In-fection-Associated Risk Factors in Prosthetic Surgery. HIP International, 22, S5-S8. [Google Scholar] [CrossRef
[28] 叶孝银, 郑咏坤. 糖尿病手术患者麻醉方式对术后感染与血流动力学及血糖的影响评价[J]. 糖尿病新世界, 2019, 22(13): 43-44.
[29] Lopez, P., Radaelli, R., Taaffe, D.R., et al. (2021) Resistance Training Load Effects on Muscle Hypertrophy and Strength Gain: Systematic Review and Network Meta-Analysis. Medicine & Science in Sports & Exercise, 53, 1206-1216. [Google Scholar] [CrossRef
[30] 曹云, 张熔熔, 袁晓敏, 等. 肠道菌群与结肠癌术后手术部位感染关系研究进展[J]. 中华医院感染学杂志, 2020, 30(20): 3196-3200.
[31] 秦晓云. 手术患者发生切口感染的手术室相关因素分析及护理[J]. 当代护士(下旬刊), 2022, 29(5): 106-108.
[32] Zhu, X., Herrera, G. and Ochoa, J.B. (2010) Immunosupression and Infection after Major Surgery: A Nutritional Deficiency. Critical Care Clinics, 26, 491-500. [Google Scholar] [CrossRef] [PubMed]