CAJ | 학술논문

目的探讨结直肠癌患者一期吻合手术后切口感染的发生率及相关影响因素.方法 2003年10月至2013年10月收治的择期结直肠癌手术患者(已除外造口患者)共1 381例,其中男性762例,女性619例;年龄20～90岁,中位年龄67岁;体重指数21.0～ 35.6 kg/m2,平均(27.7±3.7) kg/m2.记录患者术前、手术情况及术后切口感染情况,采用单因素和多因素Logistic回归分析术后切口感染的影响因素.结果术后共发生切口感染126例,感染率为9.12％,感染发生时间2 ～20 d,平均(6.7±2.9)d.多因素Logistic回归分析发现,高体重指数(OR=1.058,P=0.030)、纱垫缝合保护切口(OR=1.646,P=0.012)、术中污染(OR=10.549,P=0.000)、开腹手术(OR=2.111,P=0.001)是切口感染的独立危险因素.与纱垫保护切口相比,切口保护套可以显著降低切口感染率;与开腹手术相比,腹腔镜手术显著降低切口感染率.结论患者高体重指数、术中污染、纱垫保护切口和开腹手术是择期结直肠癌手术后切口感染的独立危险因素,使用切口保护套和腹腔镜技术有助于降低切口感染率.
목적 탐토결직장암환자일기문합수술후절구감염적발생솔급상관영향인소.방법 2003년10월지2013년10월수치적택기결직장암수술환자(이제외조구환자)공1 381례,기중남성762례,녀성619례;년령20～90세,중위년령67세;체중지수21.0～ 35.6 kg/m2,평균(27.7±3.7) kg/m2.기록환자술전、수술정황급술후절구감염정황,채용단인소화다인소Logistic회귀분석술후절구감염적영향인소.결과 술후공발생절구감염126례,감염솔위9.12％,감염발생시간2 ～20 d,평균(6.7±2.9)d.다인소Logistic회귀분석발현,고체중지수(OR=1.058,P=0.030)、사점봉합보호절구(OR=1.646,P=0.012)、술중오염(OR=10.549,P=0.000)、개복수술(OR=2.111,P=0.001)시절구감염적독립위험인소.여사점보호절구상비,절구보호투가이현저강저절구감염솔;여개복수술상비,복강경수술현저강저절구감염솔.결론 환자고체중지수、술중오염、사점보호절구화개복수술시택기결직장암수술후절구감염적독립위험인소,사용절구보호투화복강경기술유조우강저절구감염솔.
Objective To investigate the incidence of surgical site infection (SSI) and risk factors in colorectal cancer surgery patients.Methods Between October 2003 and October 2013,1 381 consecutive patients with colorectal cancer managed surgically with primary anastomosis were included in the study.There were 762 male and 619 female patients with mean body mass index (BMI) was (27.7 ± 3.7) kg/m2,aged from 20 to 90 years with a median of 67 years.Patients undergoing emergency surgery and requiring stoma creation were excluded.The patients' characteristics,surgical conditions and prognosis were recorded.Univariate and multiple logistic regression analysis were used to identify any variable predictive factors of SSI.Results One hundred twenty-six (9.12％) cases developed incisional SSI.The occurrence time for SSI was from 2 to 20 days,mean (6.7-± 2.9) days.According to multivariable logistic regression analysis,BMI (OR =1.058,P =0.030),intraoperative contamination (OR =10.549,P =0.000) and open operation as compared with a laparoscopic procedure (OR =2.111,P =0.001) were significant independent predictors of incisional SSI.There was a significant decrease in incisional SSI in wound protectors group (OR =1.646,P =0.012).Conclusion BMI and intraoperative contamination are independent predictors of incisional SSI,and wound protectors and laparoscopic surgery are associated with a lower incidence of incisional SSI following colorectal cancer surgery.