CAJ | 학술논문

目的：评估结肠直肠恶性肿瘤手术部位感染（surgical site infection，SSI）发生率，探讨其危险因素。方法前瞻性调查于2012年9月—2013年9月在重庆医科大学附属第一医院行结肠直肠恶性肿瘤切除术的392例患者，分为 SSI 组90例和对照组302例，单因素和多因素分析手术部位感染危险因素。结果SSI 组90例，罹患率23．0％。单因素分析显示在手术持续时间＞75％分位点、是否结肠造瘘、手术方式、手术切口类型、美国麻醉医师学会（ASA）评分两组差异有统计学意义（P ＜0．05），二元 Logistic 回归分析显示污染手术切口（P ＝0．016，OR ＝3．311）、手术持续时间＞75％分位点（P ＝0．000，OR ＝3．017）、结肠造瘘（P ＝0．008，OR＝2．642）、腹腔镜手术（P ＝0．016，OR＝0．523）两组差异有统计学意义。结论手术持续时间＞75％分位点、结肠造瘘和污染手术切口是结肠直肠恶性肿瘤切除术发生 SSI 独立的危险因素，而腹腔镜手术方式是保护性因素。
목적：평고결장직장악성종류수술부위감염（surgical site infection，SSI）발생솔，탐토기위험인소。방법전첨성조사우2012년9월—2013년9월재중경의과대학부속제일의원행결장직장악성종류절제술적392례환자，분위 SSI 조90례화대조조302례，단인소화다인소분석수술부위감염위험인소。결과SSI 조90례，리환솔23．0％。단인소분석현시재수술지속시간＞75％분위점、시부결장조루、수술방식、수술절구류형、미국마취의사학회（ASA）평분량조차이유통계학의의（P ＜0．05），이원 Logistic 회귀분석현시오염수술절구（P ＝0．016，OR ＝3．311）、수술지속시간＞75％분위점（P ＝0．000，OR ＝3．017）、결장조루（P ＝0．008，OR＝2．642）、복강경수술（P ＝0．016，OR＝0．523）량조차이유통계학의의。결론수술지속시간＞75％분위점、결장조루화오염수술절구시결장직장악성종류절제술발생 SSI 독립적위험인소，이복강경수술방식시보호성인소。
Objective To evaluate the incidence of surgical site infection (SSI)in patients with colorectal cancer and identify the risk factors of SSI.Methods A total of 392 patients who underwent colorectal cancer resection at the First Affiliated Hospital of Chongqing Medical University between September 2012 and September 2013 were included and analyzed in terms of the presence of SSI.SSI risk factors were identified by both univariate and multivariate analysis.Results The overall incidence of SSI was 23.0%.Univariate analysis showed that duration of operation above 75 th percentile,colostomy,surgical procedure, type of surgical incision,and American Society of Anesthesiologists (ASA)score were significantly associated with higher risk of SSI (P <0.05).Binary logistic regression suggested that duration of operation above 75 th percentile (P = 0.000,OR =3.017),colostomy (P =0.008,OR=2.642),Contaminated incision (P =0.016,OR=3.311)and laparoscopic surgery (P =0.016,OR=0.523)were significantly different in terms of presence or absence of SSI.Conclusions Duration of operation above 75th percentile,colostomy and contaminated incision are independent risk factors,while laparoscopic surgery is a protective factor for SSI in patients with colorectal cancer.