[1]邢彦峰,巨超龙.结直肠癌患者术后感染的危险因素及病原菌和耐药性分析[J].新乡医学院学报,2018,35(2):110-113.[doi:10.7683/xxyxyxb.2018.02.007]
　XING Yan-feng,JU Chao-long.Analysis of the risk factors，pathogenic bacteria and drug resistance of postoperative infection in patients with colorectal cancer[J].Journal of Xinxiang Medical University,2018,35(2):110-113.[doi:10.7683/xxyxyxb.2018.02.007]
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结直肠癌患者术后感染的危险因素及病原菌和耐药性分析
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年2
页码:
110-113
栏目:
临床研究
出版日期:
2018-02-05

文章信息/Info

Title:
Analysis of the risk factors，pathogenic bacteria and drug resistance of postoperative infection in patients with colorectal cancer
作者:
邢彦峰; 巨超龙
（铜川矿务局中心医院外科，陕西　铜川　727000）
Author(s):
XING Yan-feng; JU Chao-long
（Department of Surgery，the Central Hospital of Tongchuan Mining Bureau，Tongchuan 727000，Shaanxi Province，China）
关键词:
结直肠癌; 术后感染; 危险因素; 病原菌; 耐药性
Keywords:
colorectal cancer; postoperative infection; risk factor; pathogenic bacteria; drug resistance
分类号:
R735.3
DOI:
10.7683/xxyxyxb.2018.02.007
文献标志码:
A
摘要:
目的　探讨结直肠癌患者术后感染的危险因素及病原菌分布和耐药情况。方法　选取2013年6月至2017年6月于铜川矿务局中心医院进行手术治疗的结直肠癌患者300例，根据术后是否发生感染将患者分为感染组和非感染组；对2组患者的临床资料进行比较，并采用logistic回归模型分析结直肠癌患者术后感染的危险因素；应用全自动细菌培养仪进行细菌培养，药物敏感性试验采用Kirby-Bauer法。结果　300例结直肠癌患者术后发生切口感染61例（感染组），未发生切口感染239例（非感染组），术后感染率为20.33%（61/300）。2组患者的手术方式、红细胞计数及白蛋白、前白蛋白、血红蛋白水平比较差异有统计学意义（P<0.05），但2组患者的性别、年龄、体质量指数、糖尿病史、腹部手术史、吸烟史、饮酒史、手术时间、术中出血量、住院时间、导尿管留置时间、白细胞计数及C-反应蛋白水平比较差异均无统计学意义（P>0.05）。多因素logistic回归分析显示，白蛋白和前白蛋白水平降低是结直肠癌患者术后感染的独立危险因素（P<0.05）。61例结直肠癌术后感染患者中，共检出病原菌52株，其中革兰阴性菌38株（73.08%），革兰阳性菌10株（19.23%），真菌4株（7.69%）。大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、铜绿假单胞菌对氨苄西林、头孢克洛、头孢曲松、头孢唑肟、头孢吡肟、头孢哌酮、头孢他啶和氧氟沙星均有较高的耐药率，而对哌拉西林、亚胺培南和阿米卡星耐药率较低。结论　结直肠癌患者术后感染率较高，白蛋白和前白蛋白水平降低是结直肠癌患者术后感染的独立危险因素；革兰阴性菌是结直肠癌患者术后感染的主要病原菌，对常用抗菌药物具有较高的耐药性。
Abstract:
Objective　To analyze the risk factors for postoperative infection of patients with colorectal cancer，and to investigate the distribution of pathogenic bacteria and drug resistance.Methods　A total of 300 patients with colorectal cancer who underwent operation were selected from June 2013 to June 2017 in the Central Hospital of Tongchuan Mining Bureau，and the patients were divided into the infection group and the non-infection group according to the postoperative infection.The clinical data were compared between the two groups，and the risk factors for postoperative infection in colorectal cancer patients were analyzed by logistic regression.The total automatic bacterial culture apparatus was used for bacterial culture，and the drug sensitivity test was carried out by Kirby-Bauer.Results　Among the 300 colorectal cancer patients，there were 61 cases of incision infection （infection group） and 239 cases without incision infection （non-infection group） after operation，the postoperative infection rate was 20.33% （61/300）.There were significant differences in the operation method，red blood cell counts，the levels of albumin，prealbumin and hemoglobin between the two groups （P<0.05）；but there was no significant difference in sex，age，body mass index，diabetes mellitus history，abdominal surgery history，smoking history，drinking history，operation time，intraoperative bleeding volume，hospitalization time，indwelling time of urethral catheter，white blood cells and C-reactive protein levels between the two groups（P>0.05）.Multiple factor logistic regression analysis showed that the decrease of albumin and prealbumin level was the independent risk factor for postoperative infection in patients with colorectal cancer （P<0.05）.A total of 52 strains of pathogenic bacteria were detected in 61 cases of colorectal cancer combined with postoperative infection，including 38 strains of gram negative bacteria （73.08%），10 strains of gram positive bacteria （19.23%） and 4 strains of fungi （7.69%）.Escherichia coli，Klebsiella pneumoniae，Enterobacter cloacae，Pseudomonas aeruginosa had high drug resistance to ampicillin，cefaclor，ceftriaxone，ceftizoxime，cefepime，cefoperazone，ceftazidime and ofloxacin；but they had low drug resistance to piperacillin，imipenem and amikacin.Conclusion　The incidence of postoperative infection in patients with colorectal cancer is higher，the decrease of albumin and prealbumin is the independent risk factor for postoperative infection in patients with colorectal cancer.Gram-negative bacteria are the main pathogens of postoperative infection in patients with colorectal cancer and have high resistance to common antibiotics.

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更新日期/Last Update: 2018-02-05