结直肠手术的手术感染发生率及危险因素：一项前瞻性队列研究。

Incidence of surgical infection and risk factors in colorectal surgery - A prospective cohort study.

机构信息

Department of General and Digestive System Surgery, Hospital Universitario de Móstoles.

International Doctoral Program, Universidad Rey Juan Carlos.

出版信息

Cir Cir. 2021;89(2):156-162. doi: 10.24875/CIRU.20000205.

DOI:10.24875/CIRU.20000205

PMID:33784283

Abstract

OBJECTIVE

The objective was to measure the incidence of surgical site infection (SSI) and identify risk factors, in patients undergoing elective surgery of the colon and rectum.

MATERIALS AND METHODS

A prospective cohort study was performed from January 2017 to December 2018.

RESULTS

A total of 130 patients were studied. The cumulative incidence of SSI was 12.3%. The 56.25% were superficial wound infections and the 31.25%, organ-space infection. The risk factors significantly associated with SSI were the non-administration of pre-operative oral nutrition, diabetes mellitus, heart disease, symptomatic state at the diagnosis of colorectal cancer (CRC), and ≥ 2 altered nutritional biochemical parameters at diagnosis. After multivariate , risk factors associated with SSI were: non-administration of preoperative enteral nutrition (odds ratio [OR] = 0.27; 95% confidence interval [CI]: 0.07-1.0), DM (OR = 3.0; 95% CI: 0.9-9.9), the heart disease (OR = 4.6; 95% CI: 1.1-18.6), and laparoscopic surgery (OR = 0.28; 95% CI: 0.08-0.97). The average stay was higher in patients with a diagnosis of SSI (11.9 vs. 9.2 days).

CONCLUSIONS

Independent risk factors for SSI in CRC were the non-administration of pre-operative enteral nutrition, the existence of heart disease, and open surgery.

摘要

目的

测量接受结肠和直肠择期手术患者的手术部位感染（SSI）发生率并确定相关风险因素。

材料与方法

本研究为前瞻性队列研究，时间范围为 2017 年 1 月至 2018 年 12 月。

结果

共纳入 130 例患者，SSI 的累积发生率为 12.3%。其中 56.25%为浅表切口感染，31.25%为器官间隙感染。与 SSI 显著相关的风险因素是非术前口服营养支持、糖尿病、心脏病、结直肠癌（CRC）诊断时的症状状态以及诊断时≥2 项改变的营养生化参数。多变量分析后，与 SSI 相关的风险因素包括：未进行术前肠内营养（比值比 [OR] = 0.27；95%置信区间 [CI]：0.07-1.0）、糖尿病（OR = 3.0；95%CI：0.9-9.9）、心脏病（OR = 4.6；95%CI：1.1-18.6）和腹腔镜手术（OR = 0.28；95%CI：0.08-0.97）。诊断为 SSI 的患者平均住院时间更长（11.9 天 vs. 9.2 天）。