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CONUT评分在预测手术部位感染风险中的应用价值

[Usefulness of the CONUT Score for Predicting the Risk of Surgical Site Infections].

作者信息

Kuboyama Yu, Mazaki Junichi, Wada Takahiro, Enomoto Masanobu, Ishizaki Tetsuo, Nagakawa Yuichi, Katsumata Kenji, Tsuchida Akihiko

机构信息

Dept. of Gastrointestinal and Pediatric Surgery, Tokyo Medical University.

出版信息

Gan To Kagaku Ryoho. 2019 Dec;46(13):2401-2403.

Abstract

BACKGROUND

Surgical site infections(SSIs)occur at a high frequency in patients after rectal cancer surgery and are readily aggravated. Therefore, prophylactic measures for infections based on the evaluation of the patient's perioperative risk are very important. We investigated risk factors of SSI onset in patients after rectal cancer surgery.

METHODS

In total, 66 patients with rectal cancer who underwent resection in our department between January 2015 and December 2016 were retrospectively examined.

RESULTS

The patients in our study included 38 men and 28 women with a median age of 66 years and a median BMI of 21.3 kg/m2. Fifteen patients underwent laparotomy and 51 underwent laparoscopy. Among 66 patients, 24 had an artificial anus. The median operative time was 367 minutes, median bleeding loss was 100 mL, and median Controlling Nutritional Status(CONUT)score was 2. Twenty patients developed SSI after rectal cancer surgery. Univariate analysis demonstrated that operative time(p=0.004, OR: 1.005, 95%CI: 1.002-1.009)and CONUT score(p=0.035, OR: 1.386, 95%CI: 1.023-1.878) were significant risk factors for SSI development. Multivariate analysis also demonstrated that operative time(p=0.003, OR: 1.006, 95%CI: 1.002-1.010)and CONUT score(p=0.025, OR: 1.508, 95%CI: 1.053-2.161)were significant risk factors for SSI development.

CONCLUSIONS

The CONUT score was identified as a significant preoperative risk factor for SSI after rectal cancer surgery in both the univariate and multivariate analyses. Therefore, the preoperative evaluation using the CONUT score may be useful for predicting the risk of SSI in patients undergoing rectal cancer surgery.

摘要

背景

直肠癌手术后患者手术部位感染(SSIs)发生率高且易加重。因此,基于患者围手术期风险评估的感染预防措施非常重要。我们调查了直肠癌手术后患者发生SSI的危险因素。

方法

回顾性研究了2015年1月至2016年12月在我科接受切除术的66例直肠癌患者。

结果

我们研究中的患者包括38名男性和28名女性,中位年龄66岁,中位体重指数21.3kg/m²。15例患者接受开腹手术,51例接受腹腔镜手术。66例患者中,24例有人造肛门。中位手术时间为367分钟,中位失血量为100mL,中位控制营养状况(CONUT)评分为2分。20例患者在直肠癌手术后发生SSI。单因素分析显示,手术时间(p=0.004,OR:1.005,95%CI:1.002-1.009)和CONUT评分(p=0.035,OR:1.386,95%CI:1.023-1.878)是SSI发生的显著危险因素。多因素分析也显示,手术时间(p=0.003,OR:1.006,95%CI:1.002-1.010)和CONUT评分(p=0.025,OR:1.508,95%CI:1.053-2.161)是SSI发生的显著危险因素。

结论

在单因素和多因素分析中,CONUT评分均被确定为直肠癌手术后SSI的重要术前危险因素。因此,使用CONUT评分进行术前评估可能有助于预测直肠癌手术患者发生SSI的风险。

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