【摘要】 为分析结直肠肿瘤切除术后手术部位感染发生率及病原菌分布情况,为临床提供参考依据。选择2017年1月至2018年12月在我院诊治的结直肠肿瘤切除术后患者240例为研究对象,将其分为感染组46例与非感染组194例,分析其术前及术后患者感染因素、感染病原菌分布及构成比进行回归性分析。结果显示,单因素分析中,患者术前有肠梗阻、合并糖尿病及贫血因素易引发感染(P <0.05);性别、年龄及腹部手术史因素与感染无关(P>0.05);单因素分析中,吻合口漏、使用吻合器、联合脏器切除术、手术方式是术后感染因素(P <0.05),而肿瘤部位不是术后感染因素(P>0.05);感染患者合格标本中检测出病原菌84株;革兰阳性球菌29株,构成比34.52%;革兰阴性杆菌51株,构成比60.72%;其他4株,构成比4.76%;多因素Logistic回归性分析发现,合并糖尿病、吻合口漏、联合脏器切除术、手术方式均为结直肠肿瘤术后感染独立危险因素。结果表明,结直肠肿瘤切除术后患者因多因素影响导致手术部位感染发生率较高,其中以革兰阴性杆菌感染菌为主,应采取有效措施,减少术后手术部位感染,加快机体恢复,改善预后。更多还原

【Abstract】 This study was to analyse the infected rate and pathogenic bacterium of operative sites after resection of colorectal tumor,so as to provide basis for clinical practice,enrolled 240 patients surgically treated in author’s hospital(2017-01-2018-12),and divided them into infection group(46 cases)and non-infection group(194 cases),then tookregression analysis before and after procedure on patient’s infective facotrs,pathogenic bacterium distribution and their constructive ratio.As results,univariate analysis showed if before procedure patients suffered from intestinal obstruction,complicated DM,and enemia,then they would be easily elicited infection(P <0.05),but without relation to their gender,age,and abdominal surgical history(P >0.05);And postoperative infective factors were stoma leakage,stapler use,and complicated organ resection(P <0.05),but neoplasms sites were not ones(P >0.05);in qualified patients’ specimen pathogenic bacterium were detected out in 84 strains:G+coccus in 29 strains(ratio of 34.52%),Gbacterium in 51 strains(ratio of 60.42%),and other in 4 strains(ratio of 4.76%);multi-variate regression anaysis showed stoma leakage,complicated DM,combined organ resection,as well different procedures were all of independent risk factors resulting in postoperative infection.Results show that in the patients subjected to resection of colorectal tumors due to multi-factor influencing the infected rate in operative sites increases,which predominated by G-bacterium,thereby it should be taking effective measures to reduce infection in operative sites,and to accelerate body rehabilitation,thus improve patients’ prognosis.更多还原