子宫内膜癌子宫切除术术后手术部位感染的预测因素：回顾性分析。
Predictive factors of surgical site infection after hysterectomy for endometrial carcinoma: a retrospective analysis.
机构信息
Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Soochow University, Changzhou, China.
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, No. 188 Shizi Road, Suzhou, Jiangsu, China.
出版信息
BMC Surg. 2021 Jun 14;21(1):292. doi: 10.1186/s12893-021-01264-6.
BACKGROUND
Surgical site infection (SSI) is a common postoperative complication. We aimed to analyze the potential risk factors of SSI in patients with endometrial carcinoma.
METHODS
Patients with endometrial carcinoma who underwent surgery treatment in our hospital from Sept 1, 2018 to August 31, 2020 were included. We retrospectively compared the characteristics of SSI and no SSI patients, and logistic regression analyses were performed to identify the risk factors of SSI in patients with endometrial carcinoma.
RESULTS
A total of 318 postoperative patients with endometrial carcinoma were included. The incidence of SSI in patients with endometrial carcinoma was 14.47 %. There were significant differences on the FIGO stage, type of surgery, durations of drainage, postoperative serum albumin and postoperative blood sugar (all p < 0.05), and no significant differences on the age, BMI, hypertension, diabetes, hyperlipidemia, estimated blood loss, length of hospital stay were found (all p > 0.05). FIGO stage IV (HR3.405, 95 %CI 2.132-5.625), open surgery (HR2.692, 95 %CI 1.178-3.454), durations of drainage ≥ 7 d (HR2.414,95 %CI 1.125-2.392), postoperative serum albumin < 30 g/L (HR1.912,95 %CI 1.263-2.903), postoperative blood sugar ≥ 10 mmol/L (HR1.774,95 %CI 1.102-2.534) were the independent risk factors of SSI in patients with endometrial carcinoma (all p < 0.05).
CONCLUSIONS
Measures including reasonable control of serum albumin and blood glucose levels, minimally invasive surgery as much as possible, timely assessment of drainage and early removal of the tube may be beneficial to reduce the postoperative SSI in in patients with endometrial carcinoma.
背景
手术部位感染（SSI）是一种常见的术后并发症。我们旨在分析子宫内膜癌患者 SSI 的潜在危险因素。
方法
纳入 2018 年 9 月 1 日至 2020 年 8 月 31 日在我院接受手术治疗的子宫内膜癌患者。回顾性比较 SSI 和非 SSI 患者的特征，并进行逻辑回归分析，以确定子宫内膜癌患者 SSI 的危险因素。
结果
共纳入 318 例术后子宫内膜癌患者。子宫内膜癌患者 SSI 的发生率为 14.47%。FIGO 分期、手术类型、引流时间、术后血清白蛋白和术后血糖差异有统计学意义（均 P<0.05），而年龄、BMI、高血压、糖尿病、高血脂、估计失血量、住院时间差异无统计学意义（均 P>0.05）。FIGO 分期 IV（HR3.405，95%CI 2.132-5.625）、开腹手术（HR2.692，95%CI 1.178-3.454）、引流时间≥7d（HR2.414，95%CI 1.125-2.392）、术后血清白蛋白<30g/L（HR1.912，95%CI 1.263-2.903）、术后血糖≥10mmol/L（HR1.774，95%CI 1.102-2.534）是子宫内膜癌患者 SSI 的独立危险因素（均 P<0.05）。
结论
包括合理控制血清白蛋白和血糖水平、尽可能微创、及时评估引流和尽早拔管等措施，可能有助于降低子宫内膜癌患者术后 SSI 的发生率。
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