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目的分析胃癌患者手术部位感染(SSI)相关因素和病原菌分布特点,为临床预防控制SSI提供依据。方法回顾性调查2010年1月-2013年9月住院并手术的287例胃癌患者临床资料,系统收集相关资料,运用统计方法对各SSI相关因素进行检验,分析SSI的相关危险因素和病原菌分布,探讨SSI的预防控制措施。结果 287例胃癌手术患者发生SSI 26例,发生率为9.06%,其中切口感染19例占73.08%、腹腔感染7例占26.92%;单因素分析显示,年龄>60岁、ASA评分≥3分、肿瘤分期≥Ⅲ期、合并糖尿病、术前住院时间≥7d,手术时间≥3h、术中输血均为SSI危险因素(P<0.05),而患者性别和预防性应用抗菌药物时间与SSI无相关性;检出病原菌中革兰阴性菌占61.29%、革兰阳性菌占35.48%、真菌占3.23%,主要以大肠埃希菌和金黄色葡萄球菌为主,分别占29.03%和22.58%,其次是铜绿假单胞菌占12.90%。结论胃癌SSI相关因素多,应针对性采取相应的措施,选用有效的抗菌药物,预防和控制SSI的发生。
Objective To analyze the related factors and pathogens distribution of surgical site infection (SSI) in patients with gastric cancer and provide basis for clinical prevention and control of SSI. Methods The clinical data of 287 gastric cancer patients hospitalized and operated from January 2010 to September 2013 were retrospectively collected. Relevant data were systematically collected and the related factors of SSI were tested by statistical methods. The related risk factors and pathogenic bacteria distribution of SSI were analyzed. Discuss SSI prevention and control measures. Results The incidence of SSI in 287 cases of gastric cancer patients was 26 cases (9.06%), of which 19 cases (73.08%) and 7 cases (26.92%) had abdominal incision infection. Univariate analysis showed that ASA score ≥3, There was no significant correlation between gender and prophylactic antimicrobial time and SSI in patients with stage Ⅲ disease, diabetes mellitus, preoperative hospitalization ≥7 days, operation time ≥3 hours, intraoperative blood transfusion were all risk factors for SSI (P <0.05) ; Gram-negative bacteria accounted for 61.29%, Gram-positive bacteria accounted for 35.48%, fungi accounted for 3.23%, mainly Escherichia coli and Staphylococcus aureus, accounting for 29.03% and 22.58% respectively, followed by Pseudomonas aeruginosa accounted for 12.90%. Conclusion There are many related factors of SSI in gastric cancer, and the corresponding measures should be taken accordingly. Effective antimicrobial agents should be selected to prevent and control the occurrence of SSI.