【摘要】 目的:研究结肠癌术后切口感染的发生率,并分析相关危险因素。方法:回顾分析2014年1月至2017年12月120例腹腔镜结肠癌根治手术患者(腹腔镜组)及120例开放手术患者(开放组)的临床资料,比较两组切口感染率,并进行相关影响因素分析。结果:240例患者中19例发生切口感染,感染率为7.92%;培养出28株细菌,其中革兰阳性菌占35.71%,革兰阴性菌占64.29%。单因素分析显示,腹腔镜组切口感染率为4.2%,开放组为11.7%,切口感染发生率与手术方式具有相关性(P=0.031)。术前白蛋白小于35 g/L的患者切口感染率显著增加(19.4%vs. 5.9%,P=0.007)。切口感染组患者术后排气时间明显延长,但住院费用未明显增加。多因素logistic回归分析显示术前低蛋白血症、术后排气时间是结肠癌根治术后切口感染的独立危险因素,而手术方式不是独立危险因素。结论:腹腔镜结肠癌手术在切口感染方面优于开放手术,但不是影响结肠癌术后切口感染的独立因素。术前低蛋白血症、术后排气时间是影响结肠癌患者切口感染的独立因素。更多还原

【Abstract】 Objective: To study the surgical site infection( SSI) in patients with colon cancer and analyze the related risk factors.Methods: The clinical data and SSI rates between 120 patients who underwent traditional open surgery and 120 patients who underwent laparoscopic resection from Jan.2014 to Dec.2017 were retrospectively analyzed. Univariate and multivariable analyses were performed for 12 risk factors potentially related to SSI using the SPSS 13.0 software. Results: The overall incidence of SSI in the whole group was 7.92%. Totally 28 bacteria strains were isolated from 19 patients,Gram-positive bacteria accounted for 35. 71% and other64.29% were Gram-negative.Univariate analysis showed the SSI rate was 4.2% in laparoscopic surgery group and 11.7% in the open surgery group,which indicated that SSI was statistically related with surgical methods( P = 0.031). However,the patients with the low serum albumin level( <35 g/L) suffered a higher SSI rate compared to those with normal serum albumin level( 19.4% vs.5.9%,P =0.007).The time of postoperative exhaust restoring in the infected group was significantly prolonged than the uninfected group.However,hospitalization expense was not significantly increased.Multivariate logistic regression analysis showed that pre-operative serum albumin level and post-operative exhaust restoring time were the independent risk factors of SSI in colon cancer patients. Laparoscopic surgery was not the independent risk factor.Conclusions: Regarding the SSI of the colon cancer patients,laparoscopic surgery is superior to the traditional surgery,but it is not the independent risk factor.Pre-operative serum albumin level and the time of post-operative exhaust restoring are the independent risk factors.更多还原