【摘要】 目的 研究造口回纳术后切口感染的现状并对危险因素进行探讨，构建风险预测模型。方法 本研究为前瞻性队列研究，招募浙江大学医学院附属第一医院2023年9月至2024年2月行造口回纳术的患者为研究对象，随访30 d。采用多因素logistic回归分析造口回纳术后切口感染的影响因素并构建风险预测模型，应用受试者工作特征曲线、Hosmer-Lemeshow检验和列线图分析模型预测价值。结果 310例患者中发生造口回纳术后切口感染有83例，手术切口感染的发生率为26.8%。多因素logistic回归分析结果表明，术前造口周围皮炎、造口术后切口感染史、预防性使用抗生素是造口回纳术后切口感染的影响因素(P<0.05);Logit(P)=-0.890+1.676×造口术后切口感染史+1.208×术前造口周围皮炎-0.948×预防性使用抗生素。受试者工作特征曲线下面积为0.730,约登指数0.412,最佳截断值0.247,模型特异度74.9%,敏感度66.3%。Hosmer-Lemeshow检验，P=0.926。结论 造口回纳术后切口感染发生率较高，术前造口周围皮炎、造口术后切口感染史、预防性使用抗生素是造口回纳术后切口感染的独立预测因子，基于上述因素构建的预测模型预测效果较好。更多还原

【Abstract】 Objective To investigate the prevalence and risk factors of surgical site infection following stoma reversal and to develop a prediction model.Methods This was a prospective cohort study enrolling patients who underwent stoma reversal at the First Affiliated Hospital of Zhejiang University School of Medicine from September 2023 to February 2024, with a 30-day follow-up. Multivariate logistic regression was employed to identify risk factors for surgical site infection post-stoma reversal and to develop a predictive model. The model’s predictive accuracy was assessed using the receiver operating characteristic(ROC) curve, Hosmer-Lemeshow test, and a nomogram.Results Among 310 patients, 83 developed surgical site infection after stoma reversal, with an infection rate of 26.8%.Multivariate logistic regression identified peristomal dermatitis pre-surgery, a history of surgical site infection post-stoma surgery, and prophylactic antibiotic used as independent risk factors for incisional infection following stoma reversal(P<0.05).The logistic regression equation was Logit(P) =-0.890 + 1.676 ×(history of surgical site infection post-stoma surgery)+1.208×(peristomal dermatitis pre-surgery)-0.948×(prophylactic antibiotic use).The area under the ROC curve was 0.730, with a Youden index of 0.412 and an optimal cut-off value of 0.247, resulting in a model specificity of 74.9% and sensitivity of 66.3%.The Hosmer-Lemeshow test indicated good model calibration(P=0.926).Conclusion The rate of surgical site infection following stoma reversal is high. Peristomal dermatitis pre-surgery, a history of surgical site infection post-stoma surgery, and prophylactic antibiotic use are significant predictors of surgical site infection post-stoma reversal.The developed on model demonstrates satisfactory prediction performance.更多还原