摘要
目的探讨肝胆外科手术患者发生腹腔感染的风险因素。方法选取2016年12月-2017年12月我院收治的肝胆外科手术患者76例,对所有入组患者的详细诊疗资料进行回顾性分析,并使用Cox回归模型分析肝胆外科手术患者发生腹腔感染的独立风险因素。结果 76例肝胆外科手术患者中有30例出现腹腔感染,占总患者例数的39.5%;手术时长、静脉导管的留置时间、呼吸机使用时长以及患者是否合并糖尿病是影响肝胆外科手术患者发生腹腔感染的独立风险因素,差异存在统计学意义(P<0.05);共提取到12类、62株细菌,占比最高的分别是大肠埃希菌(30.6%)、鲍曼不动杆菌(19.4%)及粪肠球菌(16.1%);大肠埃希菌对抗菌药物耐药性高于鲍曼不动杆菌(P<0.05)。结论手术时长、静脉导管的留置时间、呼吸机使用时长以及患者是否合并糖尿病是肝胆外科手术患者发生腹腔感染的独立风险因素。针对分析结果所提示的风险因素给予患者相应的干预措施,以降低肝胆外科手术患者在手术后发生腹腔感染的风险;同时在给予发生腹腔感染的患者进行治疗的过程中,要根据细菌培养结果来选择合适的药物进行针对性的抗菌治疗。
Objective To explore the risk factors for abdominal infections in patients undergoing hepatobiliary surgery.Methods Seventy-six cases of hepatobiliary surgery patients admitted to our hospital between December 2016 and December 2017were selected for retrospective analysis of the data on their diagnosis and treatment. A COX regression model was used to analyzethe independent risk factors for the occurrence of abdominal infections in patients undergoing hepatobiliary surgery. Results amongthe 76 patients who had undergone hepatobiliary surgery, 30 had abdominal infections, accounting for 39. 5% of the total patients. The duration of surgery, duration of indwelling of the venous catheter, the duration of use of the ventilator, and whetherthe patient was diabetic were independent risk factors for the occurrence of abdominal infections in patients after hepatobiliary surgery, with statistically significant differences （P〈0. 05）. A total of 12 types and 62 strains of bacteria were extracted. The dominating one was escherichia coli （30. 6%）, followed by acinetobacter baumannii （19. 4%） and enterococcus faecalis （16. 1%）.The resistance of escherichia coli to antimicrobial agents was higher than that of acinetobacter baumannii （P〈0. 05）. ConclusionThe duration of surgery, duration of indwelling of the venous catheter, duration of use of the ventilator, and whether the patienthas diabetes are independent risk factors for celiac infections in patients after hepatobiliary surgery. In order to reduce the risk ofabdominal infections after hepatobiliary surgery, corresponding intervention measures should be taken according to the risk factorsindicated by the results of analysis. Meanwhile, during the treatment of patients with celiac infection, appropriate drugs should beselected according to the results of bacterial culture for targeted antibacterial treatment.
作者
谭大勇
李娜
王晓临
张国华
TAN Dayong;LI Na;WANG Xiaolin;ZHANG Guohua(Hepatobiliary Department,Affiliated Hospital of Qinghai University,Xining 810001,China)
出处
《解放军预防医学杂志》
CAS
2018年第11期1405-1408,共4页
Journal of Preventive Medicine of Chinese People's Liberation Army
基金
青海省2015年医药卫生科技项目课题(指导性项目)(No.Y2015-24)
关键词
肝胆外科
腹腔感染
术后感染
风险因素
细菌培养
耐药性
hepatobiliary surgery
celiac infection
postoperative infection
risk factors
bacterial culture
drug resistance
