摘要
目的对老年结肠癌患者行根治性结肠癌切除术后手术部位感染(SSI)的病历资料进行分析,探讨发生SSI的危险因素并构建预测模型。方法回顾性收集2010年1月至2021年9月于西京医院消化外科接受结肠癌根治术的老年患者病历信息。经筛选最终纳入1542例患者临床数据。根据是否发生SSI分为SSI组(49例)与non-SSI组(1493例),并进行单因素及多因素分析。构建列线图和机器学习预测模型。结果单因素分析显示肿瘤大体类型、消化道重建方式、是否使用抗生素、肿瘤直径、术前白蛋白水平、术后白细胞计数在两组间存在统计学差异(P<0.05,P<0.01)。多因素回归分析显示肿瘤直径、术前白蛋白水平、术后白细胞计数是老年患者结肠癌根治术后SSI发生的独立危险因素。结论根治性结肠癌切除术后发生SSI是多种因素共同作用导致的术后不良事件。对老年患者而言,肿瘤直径较大、术前白蛋白水平较低、术后白细胞计数较高的患者,更容易发生SSI,临床工作中应引起足够重视。
Objective To analyze the medical records of postoperative surgical site infection(SSI)in elderly patients with colon cancer after radical resection of colon cancer,and to explore the risk factors for the occurrence of SSI and construct a prediction model.Methods The medical records of elderly patients who underwent radical resection of colon cancer in the Department of Digestive Surgery,Xijing Hospital from January 2010 to September 2021 were retrospectively collected.After screening,the clinical data of 1542 patients were finally included in this study.According to the occurrence of SSI,the patients were divided into SSI group(49 cases)and non-SSI group(1493 cases),and univariate and multivariate analyses were performed.Nomogram and machine learning prediction models were constructed.Results Univariate analysis showed statistical differences in tumor gross type,digestive tract reconstruction method,whether antibiotics were used,tumor diameter,preoperative albumin level,and postoperative leukocyte count between the two groups(P<0.05,P<0.01).Multivariate regression analysis showed that tumor diameter,preoperative albumin level,and postoperative leukocyte count were independent risk factors for the occurrence of SSI after radical resection of colon cancer in elderly patients.Conclusion The occurrence of SSI after radical resection of colon cancer is a postoperative adverse event caused by multiple factors.For elderly patients,those with larger tumor diameter,lower preoperative albumin level,and higher postoperative leukocyte count are more likely to develop SSI,which should be given sufficient attention in clinical work.
作者
王晓谦
周威
杨万里
段理理
李一丁
钮瞭然
陈俊峰
范阿强
谢奇斌
洪流
WANG Xiaoqian;ZHOU Wei;YANG Wanli;DUAN Lili;LI Yiding;NIU Liaoran;CHEN Junfeng;FAN Aqiang;XIE Qibin;HONG Liu(Department of Digestive Surgery,Xijing Hospital,Air Force Medical University,Xi'an 710032,China)
出处
《空军军医大学学报》
CAS
2023年第9期890-893,共4页
Journal of Air Force Medical University
基金
国家自然科学基金(82073210)
陕西省重点研发计划项目(2019ZDLSF01-02-01,2018SF-240)
空军军医大学西京医院助推计划项目(XJZT18ML06)
空军军医大学军事医学“珠峰工程”项目(2018YYZT02)。
关键词
危险因素分析
结肠癌根治术
手术部位感染
analysis of risk factors
radical resection of colon cancer
surgical site infection
