Coakley Brian A, Divino Celia M
Department of Surgery, The Mount Sinai Medical Center, New York, New York, USA.
Am Surg. 2012 Apr;78(4):481-4.
Surgical-site infections (SSIs) remain a major source of morbidity after colectomy for fulminant ulcerative colitis (UC). Identifying UC patients at elevated risk of developing SSIs might improve postoperative outcomes. Our goal was to identify preoperative factors, which could predict SSI development in the postoperative UC population. The records of 59 patients treated by colectomy for fulminant UC from 2004 to 2009 were retrospectively reviewed and statistically analyzed. Few differences were observed between patients who developed postoperative complications and those who did not. Twenty patients sustained a total of 27 complications, with superficial SSIs being the single most common event. Multivariate analysis identified diabetes, white blood cell count > 15 cells/mm(3), intraoperative blood loss > 200 cc, and intraoperative blood transfusion to all be independent predictors for the development of postoperative SSIs. These four factors were all able to independently predict SSIs. Postoperative UC patients with these risk factors might benefit from heightened wound surveillance or closer follow-up.
对于暴发性溃疡性结肠炎(UC)患者而言,手术部位感染(SSIs)仍是结肠切除术后发病的主要原因。识别发生SSIs风险较高的UC患者可能会改善术后结局。我们的目标是确定可预测术后UC患者发生SSIs的术前因素。对2004年至2009年因暴发性UC接受结肠切除术治疗的59例患者的记录进行回顾性分析和统计分析。术后发生并发症的患者与未发生并发症的患者之间未观察到明显差异。20例患者共出现27种并发症,其中浅表SSIs是最常见的单一事件。多因素分析确定糖尿病、白细胞计数>15个/mm³、术中失血>200 cc以及术中输血均为术后SSIs发生的独立预测因素。这四个因素均能够独立预测SSIs。具有这些危险因素的术后UC患者可能会从加强伤口监测或密切随访中获益。