CAJ | 학술논문

目的：探讨肝门部胆管癌手术患者术后发生伤口感染的相关危险因素，以指导临床治疗。方法回顾性分析本院2010年1月-2014年12月连续595例行外科手术治疗的肝门部胆管癌患者的临床资料。将患者按照术后是否发生伤口感染分为感染组(45例)和对照组(550例)，对两组患者的一般资料、术中情况、术后并发症和伤口感染相关危险因素进行分析。结果所有患者均顺利完成手术，伤口感染45例，感染率7.6%，无因伤口感染死亡患者。多因素分析结果显示，患者的体质量指数、手术时间、胆汁培养阳性和术后胆瘘是术后伤口感染的独立危险因素(P ＜0.05)。结论肝门部胆管癌患者术前营养状态和术后胆瘘是术后伤口感染的主要危险因素。
목적：탐토간문부담관암수술환자술후발생상구감염적상관위험인소，이지도림상치료。방법회고성분석본원2010년1월-2014년12월련속595례행외과수술치료적간문부담관암환자적림상자료。장환자안조술후시부발생상구감염분위감염조(45례)화대조조(550례)，대량조환자적일반자료、술중정황、술후병발증화상구감염상관위험인소진행분석。결과소유환자균순리완성수술，상구감염45례，감염솔7.6%，무인상구감염사망환자。다인소분석결과현시，환자적체질량지수、수술시간、담즙배양양성화술후담루시술후상구감염적독립위험인소(P ＜0.05)。결론간문부담관암환자술전영양상태화술후담루시술후상구감염적주요위험인소。
Objective To investigate the related risk factors for incision infection after operation of hilar cholangiocarcinoma. Methods Clinical data about 595 hilar cholangiocarcinoma patients who underwent operation in Chinese PLA General Hospital from January 2010 to December 2014 were retrospectively analyzed. According to the inclusion criteria, patients were divided into two groups: infection group (n=45) and control group (n=550). The general data, operation situation, postoperative complications data and wound infections were statistically analyzed. Results All patients had completed the operation successfully. The incision infection occurred in 45 cases with incidence rate of 7.6%. No patients died of incision infection. Multivariate analysis showed that patients’body mass index, operation time, positive bile culture and postoperative biliary fistula were independent risk factors of incision infection (P < 0.05). Conclusion Preoperative nutritional status and postoperative biliary fistula are the main risk factors of incision infection after operation of hilar cholangiocarcinoma.