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评估腹腔镜胆囊切除术患者手术部位感染的危险因素及预防性抗生素的有效性。

Evaluating risk factors for surgical site infections and the effectiveness of prophylactic antibiotics in patients undergoing laparoscopic cholecystectomy.

作者信息

Wang Shao-Hua

机构信息

Department of General Surgery, Guangdong Hydropower Hospital, Guangzhou 511356, Guangdong Province, China.

出版信息

World J Gastrointest Surg. 2025 Jan 27;17(1):98567. doi: 10.4240/wjgs.v17.i1.98567.

Abstract

BACKGROUND

Surgical site infections (SSIs) are a significant complication in laparoscopic cholecystectomy (LC), affecting patient outcomes and healthcare costs.

AIM

To identify risk factors associated with SSIs and evaluate the effectiveness of prophylactic antibiotics in reducing these infections.

METHODS

A comprehensive retrospective evaluation was conducted on 400 patients who underwent LC from January 2022 to January 2024. Patients were divided into infected ( = 36) and non-infected ( = 364) groups based on the occurrence of SSIs. Data collected included age, diabetes mellitus status, use of prophylactic antibiotics, and specific surgical complications. Statistical analyses using SPSS (Version 27.0) involved univariate and multivariate logistic regression to determine factors influencing the risk of SSIs.

RESULTS

The use of prophylactic antibiotics significantly reduced the incidence of SSIs (² = 68.34, < 0.01). Older age (≥ 60 years) and comorbidities such as diabetes mellitus were identified as significant risk factors. Surgical complications like insufficient cystic duct stump, gallbladder perforation, and empyema also increased SSI risk. Notably, factors such as intraoperative blood loss and operation time did not significantly impact SSI occurrence.

CONCLUSION

Prophylactic antibiotics are effective in reducing the risk of SSIs in patients undergoing LC. Age, diabetes mellitus, and certain surgical complications significantly contribute to the risk. Effective management of these risk factors is essential to improve surgical outcomes and reduce the incidence of SSIs.

摘要

背景

手术部位感染(SSIs)是腹腔镜胆囊切除术(LC)中的一种重要并发症,会影响患者的预后和医疗成本。

目的

确定与手术部位感染相关的风险因素,并评估预防性使用抗生素在减少这些感染方面的有效性。

方法

对2022年1月至2024年1月期间接受LC手术的400例患者进行了全面的回顾性评估。根据手术部位感染的发生情况,将患者分为感染组(n = 36)和非感染组(n = 364)。收集的数据包括年龄、糖尿病状态、预防性抗生素的使用情况以及特定的手术并发症。使用SPSS(版本27.0)进行统计分析,采用单因素和多因素逻辑回归来确定影响手术部位感染风险的因素。

结果

预防性使用抗生素显著降低了手术部位感染的发生率(χ² = 68.34,P < 0.01)。年龄较大(≥60岁)和糖尿病等合并症被确定为重要的风险因素。胆囊管残端不足、胆囊穿孔和积脓等手术并发症也增加了手术部位感染的风险。值得注意的是,术中失血和手术时间等因素对手术部位感染的发生没有显著影响。

结论

预防性使用抗生素可有效降低接受LC手术患者发生手术部位感染的风险。年龄、糖尿病和某些手术并发症是导致风险增加的重要因素。有效管理这些风险因素对于改善手术预后和降低手术部位感染的发生率至关重要。

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