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肝胆外科手术患者的手术部位感染及其与血清维生素 D 浓度的关系。

Surgical site infection in hepatobiliary surgery patients and its relationship with serum vitamin D concentration.

机构信息

Servicio de Cirugía General y Digestiva, Hospital Miguel Servet, Zaragoza, España.

Servicio de Cirugía General y Digestiva, Hospital Miguel Servet, Zaragoza, España.

出版信息

Cir Esp (Engl Ed). 2020 Oct;98(8):456-464. doi: 10.1016/j.ciresp.2020.03.004. Epub 2020 Jul 25.

Abstract

INTRODUCTION

While several studies have examined the correlation between vitamin D concentrations and post-surgical nosocomial infections, this relationship has yet to be characterized in hepatobiliary surgery patients. We investigated the relationship between serum vitamin D concentration and the incidence of surgical site infection (SSI) in patients in our hepatobiliary surgery unit.

METHODS

Participants in this observational study were 321 successive patients who underwent the following types of interventions in the hepatobiliary surgery unit of our center over a 1-year period: cholecystectomy, pancreaticoduodenectomy, total pancreatectomy, segmentectomy, hepatectomy, hepaticojejunostomy and exploratory laparotomy. Serum vitamin D levels were measured upon admission and patients were followed up for 1 month. Mean group values were compared using a Student's T-test or Chi-squared test. Statistical analyses were performed using the Student's T-test, the Chi-squared test, or logistic regression models.

RESULTS

Serum concentrations >33.5 nmol/l reduced the risk of SSI by 50%. Out of the 321 patients analyzed, 25.8% developed SSI, mainly due to organ-cavity infections (incidence, 24.3%). Serum concentrations of over 33.5 nmol/l reduced the risk of SSI by 50%.

CONCLUSIONS

High serum levels of vitamin D are a protective factor against SSI (OR, 0.99). Our results suggest a direct relationship between serum vitamin D concentrations and SSI, underscoring the need for prospective studies to assess the potential benefits of vitamin D in SSI prevention.

摘要

简介

虽然已有多项研究探讨了维生素 D 浓度与术后医院获得性感染之间的相关性,但尚未明确其在肝胆外科患者中的关系。我们调查了我院肝胆外科患者血清维生素 D 浓度与手术部位感染(SSI)发生率之间的关系。

方法

本观察性研究纳入了在我院肝胆外科中心 1 年内接受以下类型干预的 321 例连续患者:胆囊切除术、胰十二指肠切除术、全胰切除术、节段切除术、肝切除术、肝肠吻合术和剖腹探查术。入院时测量血清维生素 D 水平,并对患者进行为期 1 个月的随访。采用 Student's T 检验或卡方检验比较组间均值。采用 Student's T 检验、卡方检验或逻辑回归模型进行统计分析。

结果

血清浓度>33.5nmol/L 可使 SSI 风险降低 50%。在分析的 321 例患者中,25.8%发生 SSI,主要为器官腔隙感染(发生率为 24.3%)。血清浓度>33.5nmol/L 可使 SSI 风险降低 50%。

结论

高血清维生素 D 水平是 SSI 的保护因素(OR,0.99)。我们的结果表明血清维生素 D 浓度与 SSI 之间存在直接关系,强调需要前瞻性研究来评估维生素 D 预防 SSI 的潜在益处。

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