摘要
目的分析腹腔镜下胃癌根治术患者发生医院感染的病原菌分布及危险因素。方法选取2018年1月至2022年9月本院收治的行腹腔镜手术治疗的胃癌患者86例,通过对所有患者一般资料情况进行记录统计,分析其术后发生医院感染的病原菌分布情况及危险因素。结果行手术治疗的86例患者中术后出现医院感染的患者有8例,感染率为9.3%;其中5例为肺部感染,占5.8%,其次为腹腔感染与切口感染,分别为2例(2.33%)和1例(1.16%)。发生医院感染的8例患者共分离培养出病原菌11株,其中较多的为革兰阴性菌,共7株,占63.6%,其次为革兰阳性菌,共4株,占36.4%。经单因素分析结果显示,经腹腔镜手术治疗的患者术后发生医院感染的影响因素包括年龄、胃癌分期、吸烟史、糖尿病史、手术时间、住院时间、留置尿管时间,差异均具有统计学意义(P<0.05);通过对上述影响因素进行多因素Logistic回归分析显示,术后患者发生医院感染的独立危险因素包括年龄≥70岁、吸烟史、糖尿病史、手术时间≥3 h(P<0.05)。结论腹腔镜下胃癌根治术患者有一定医院感染率,其中主要以革兰阴性菌为主;发生感染的独立因素包括年龄≥70岁、吸烟史、糖尿病史、TNM分期≥Ⅲ期、手术时间≥3 h、尿管留置时间≥3 d,临床应针对上述因素采取积极措施,以避免医院感染的发生。
Objective To analyze the pathogenic bacteria distribution and risk factors of nosocomial infection in patients with laparoscopic radical gastrectomy.Methods A total of 86 patients with gastric cancer who received laparoscopic surgery in hospital from January 2018 to September 2022 were selected.General data of all patients were recorded and statistically analyzed to analyze the distribution of pathogenic bacteria and risk factors of postoperative nosocomial infection.Results There were 8 cases of nosocomial infection in 86 patients after operation,the infection rate was 9.3%.Among them,5 cases were pulmonary infection,followed by abdominal infection and incision infection(2 cases and 1 case,respectively).A total of 11 strains of pathogenic bacteria were isolated and cultured from 8 patients with nosocomial infection,among which the majority were Gram-negative bacteria(7 strains,accounting for 63.6%),followed by Gram-positive bacteria(4 strains,accounting for 36.4%).Univariate analysis showed that the influencing factors of postoperative nosocomial infection in patients treated with laparoscopic surgery included age,stage of gastric cancer,history of smoking,history of diabetes,time of operation,hospital stay,and duration of indent catheter,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis of the above influencing factors showed that the independent risk factors for nosocomial infection of postoperative patients included age≥70 years old,smoking history,diabetes history and operation time≥3 h,with statistical significance(P<0.05).Conclusion The rate of nosocomial infection in patients with laparoscopic radical gastrectomy is higher,and gram-negative bacteria are the main ones.Independent factors of infection include age≥70 years old,smoking history,diabetes history,TNM stage≥Ⅲ,operation time≥3 h,catheter indentation time≥3 d.Clinical measures should be taken to avoid the occurrence of hospital infection.
作者
李丽芳
邵静涛
LI Lifang;SHAO Jingtao(Chun'an County first People's Hospital,Zhejiang 311700,China)
出处
《浙江创伤外科》
2023年第6期1024-1026,1030,共4页
Zhejiang Journal of Traumatic Surgery
关键词
腹腔镜
胃癌根治术
医院感染
病原菌
危险因素
Laparoscopy
Radical gastrectomy
Nosocomial infection
Pathogenic bacteria
Risk factor
