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肝切除术后早期预防性引流液细菌培养对预测手术部位感染发生的意义。

Significance of bacterial culturing of prophylactic drainage fluid in the early postoperative period after liver resection for predicting the development of surgical site infections.

作者信息

Ishioka Kohei, Hokuto Daisuke, Nomi Takeo, Yasuda Satoshi, Yoshikawa Takahiro, Matsuo Yasuko, Akahori Takahiro, Nishiwada Satoshi, Nakagawa Kenji, Nagai Minako, Nakamura Kota, Ikeda Naoya, Sho Masayuki

机构信息

Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

出版信息

Surg Today. 2018 Jun;48(6):625-631. doi: 10.1007/s00595-018-1629-8. Epub 2018 Jan 29.

Abstract

PURPOSES

The relationship between the results of bacterial drainage fluid cultures in the early postoperative period after liver resection and the development of surgical site infections (SSIs) is unclear. We evaluated the diagnostic value of bacterial cultures of drainage fluid obtained on postoperative day (POD) 1 after liver resection.

METHODS

The cases of all consecutive patients who underwent elective liver resection from January 2014 to December 2016 were analyzed. The association between a positive culture result and the development of SSIs was analyzed.

RESULTS

A total of 195 consecutive patients were studied. Positive drainage fluid cultures were obtained in 6 patients (3.1%). A multivariate analysis revealed that a positive drainage fluid culture was an independent risk factor for SSIs (odds ratio: 8.04, P = 0.035), and combined resection of the gastrointestinal tract was a risk factor for a positive drainage fluid culture (P = 0.006). Among the patients who did not undergo procedures involving the gastrointestinal tract, there was no association between drainage fluid culture positivity and SSIs.

CONCLUSIONS

The detection of positive culture results for drainage fluid collected on POD 1 after liver resection was associated with SSIs. However, among patients who did not undergo procedures involving the gastrointestinal tract, it was not a predictor of SSIs.

摘要

目的

肝切除术后早期细菌引流液培养结果与手术部位感染(SSIs)发生之间的关系尚不清楚。我们评估了肝切除术后第1天(POD 1)获得的引流液细菌培养的诊断价值。

方法

分析了2014年1月至2016年12月期间所有接受择期肝切除的连续患者的病例。分析了培养结果阳性与SSIs发生之间的关联。

结果

共研究了195例连续患者。6例患者(3.1%)引流液培养结果为阳性。多因素分析显示,引流液培养结果阳性是SSIs的独立危险因素(比值比:8.04,P = 0.035),胃肠道联合切除是引流液培养结果阳性的危险因素(P = 0.006)。在未进行涉及胃肠道手术的患者中,引流液培养阳性与SSIs之间无关联。

结论

肝切除术后POD 1收集的引流液培养结果阳性与SSIs相关。然而,在未进行涉及胃肠道手术的患者中,它不是SSIs的预测指标。

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