[1]马凯骅,郭明飞.腹腔镜手术术后脐部通道切口感染发生率及其危险因素分析[J].陕西医学杂志,2021,50(11):1375-1378,1386.[doi:DOI:10.3969/j.issn.1000-7377.2021.11.013]
 MA Kaihua,GUO Mingfei.Incidence and risk factors of umbilical channel incision infection after laparoscopic surgery[J].,2021,50(11):1375-1378,1386.[doi:DOI:10.3969/j.issn.1000-7377.2021.11.013]
点击复制

腹腔镜手术术后脐部通道切口感染发生率及其危险因素分析
分享到:

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年11期
页码:
1375-1378,1386
栏目:
临床研究
出版日期:
2021-11-05

文章信息/Info

Title:
Incidence and risk factors of umbilical channel incision infection after laparoscopic surgery
作者:
马凯骅1郭明飞2
(1.宝鸡市中医医院外科,陕西 宝鸡 721001; 2.榆林市星元医院 榆林市第四医院普外科,陕西 榆林 719000)
Author(s):
MA KaihuaGUO Mingfei
(Department of Surgery,Baoji Hospital of Traditional Chinese Medicine,Baoji 721001,China)
关键词:
腹腔镜手术 脐部通道 切口 感染 发生率 危险因素
Keywords:
Laparoscopic surgery Umbilical channel Incision Infection Incidence rate Risk factor
分类号:
R 565
DOI:
DOI:10.3969/j.issn.1000-7377.2021.11.013
文献标志码:
A
摘要:
目的:分析腹腔镜手术术后脐部通道切口感染发生率及其危险因素。方法:选择816例行腹腔镜手术患者作为研究对象,随访2个月,观察其术后脐部通道切口感染发生情况,根据是否发生感染分为感染组和非感染组,比较两组的临床病理因素,进行单因素分析和多因素Logistic回归分析; 使用受试者工作特征曲线(ROC)下面积(AUC)量化相关因素对脐部通道切口感染的预测效能。结果:在本研究816例行腹腔镜手术患者中,术后脐部通道切口发生感染78例,发生率为9.56%; 感染组与非感染组在性别、年龄、体重指数(BMI)、糖尿病、低白蛋白血症、手术类别、术中神经牵拉或损伤、手术时间、术后切口引流、围手术期低体温方面比较差异均有统计学意义(均P<0.05); 多因素Logistic回归分析表明,手术类别、围手术期低体温、手术时间、切口引流均是引起脐部通道切口感染的独立危险因素(均P<0.05); 感染组围手术期体温低于非感染组,切口引流时间和手术时间均长于非感染组,差异均有统计学意义(均P<0.001); 经ROC曲线分析,围手术期体温、切口引流时间联合手术时间预测脐部通道切口感染的AUC为0.915,明显大于单一因素的AUC,差异有统计学意义(P<0.05)。结论:腹腔镜手术术后脐部通道切口感染与手术类别、围手术期低体温、手术时间、切口引流有关,临床应严格掌握其独立影响因素,加强围术期管理,以期减少脐部通道切口感染发生。
Abstract:
Objective:To analyze the incidence of umbilical channel incision infection and its risk factors after laparoscopic surgery.Methods:816 patients undergoing laparoscopic surgery were selected as the research objects.They were followed up for 2 months to observe the incidence of umbilical channel incision infection.They were divided into infection group and non-infection group according to whether there was infection.The clinicopathological factors of the two groups were compared and analyzed by univariate analysis and multivariate Logistic regression analysis.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was used to quantify the predictive efficacy of related factors for umbilical channel incision infection.Results:Among 816 patients,78 cases of infection occurred in the umbilical channel incision after surgery,with an incidence rate of 9.56%.There were significant differences in gender,age,BMI,diabetes,hypoalbuminemia,surgery type,intraoperative nerve stretch or injury,operation time,postoperative incision drainage,perioperative hypothermia in the infection group and non-infection group(all P<0.05).Multivariate Logistic regression analysis showed that the type of surgery,perioperative hypothermia,operation time and incision drainage were independent risk factors for umbilical channel incision infection(all P<0.05).The perioperative temperature of the infection group was lower than that of the non-infection group,and the incision drainage time and operation time were longer than those of the non-infection group(all P<0.001).The ROC curve analysis showed that the perioperative temperature,incision drainage time combined with the operation time predicted the AUC of the umbilical channel incision infection was 0.915,which was significantly larger than the AUC of a single factor(P<0.05).Conclusion:After laparoscopic surgery,the infection of the umbilical channel incision is related to the type of operation,perioperative hypothermia,operation time,and incision drainage.The clinic should strictly grasp its independent influencing factors and strengthen the perioperative management in order to reduce the incidence of umbilical channel incision infection.Infection of the umbilical channel incision after laparoscopic surgery is related to the type of surgery,perioperative hypothermia,operation time,and incision drainage,the independent influencing factors should be strictly controlled in the clinic,and perioperative management should be strengthened in order to reduce of infection of umbilical channel incision.

参考文献/References:

[1] 刘 康,田 道.腹腔镜下脾切除术中静脉通道麻醉复合局麻对手术麻醉效果、应激指标影响的临床研究[J].陕西医学杂志,2021,50(1):68-70.
[2] 徐建庆,买赛虎,杨喜佳,等.腹腔镜手术治疗复杂性胆囊炎临床疗效研究[J].陕西医学杂志,2019,48(2):176-178.
[3] 于 波,丁玲玲,陆 斌,等.经皮穴位电刺激对腹腔镜手术全麻患者脑保护及应激作用的研究[J].陕西中医,2020,41(2):241-244.
[4] Dijk JEW,Dedden SJ,Geomini PMA,et al.Randomized controlled trial to estimate reduction in pain after laparoscopic surgery when using a combination therapy of intraperitoneal normal saline and the pulmonary recruitment manoeuvre[J].Bjog An International Journal of Obstetrics & Gynaecology,2018,125(11):1469-1476
[5] 林 填,余 江,胡彦锋,等.两孔法腹腔镜远端胃癌根治术的初步经验[J].中华胃肠外科杂志,2019,22(1):35-42.
[6] 姜景凯,朱安之,奚玉廷.经脐单一部位三通道腹腔镜手术治疗隐睾的临床有效性和安全性[J].国际泌尿系统杂志,2020,40(4):660-664.
[7] 宋晓超,赵丽娜,乔美珍,等.神经外科Ⅰ类切口手术部位感染的影响因素分析[J].中华医院感染学杂志,2019,29(12):1838-1841,1866.
[8] 何少华,汤坤彬,徐 迪,等.经脐单部位三通道腹腔镜胆总管囊肿根治术的临床体会(附48例报告)[J].腹腔镜外科杂志,2018,23(4):302-306.
[9] 吴开李,王连臣,符国宏.腹腔镜手术对穿孔性阑尾炎患者术后切口感染和免疫功能的影响[J].湖南师范大学学报:医学版,2020,17(2):108-112.
[10] Kosuga T,Ichikawa D,Komatsu S,et al.Clinical and surgical factors associated with organ/space surgical site infection after laparoscopic gastrectomy for gastric cancer[J].Surgical Endoscopy,2017,31(4):1-8.
[11] 刘 铁,孙军席,王海霞,等.持续负压引流配合间断冲洗对腹腔镜肛提肌外腹会阴联合切除术后手术部位感染的影响[J].中华胃肠外科杂志,2018,21(6):685-690.
[12] 高京海,刘晓军,金志军,等.机器人手术系统辅助的经脐单孔腹腔镜治疗早期子宫内膜癌8例临床分析[J].中华妇产科杂志,2019,54(4):266-268.
[13] 唐 佳,李冬雪,王志成.老年围术期低体温与感染的相关性研究[J].中华医院感染学杂志,2015,25(2):418-420.
[14] Koning MV,Teunissen AJW,Harst EVD,et al.Intrathecal morphine for laparoscopic segmental colonic resection as part of an enhanced recovery protocol:A randomized controlled trial[J].Regional Anesthesia and Pain Medicine,2017,43(2):1-8.
[15] 张 斌,李启刚,白 錬.快速康复外科理念在成年结直肠癌患者腹腔镜手术围术期的应用疗效的Meta分析[J].重庆医学,2018,47(18):2449-2453,2459.
[16] 蒋 晨,傅琦博,方伟林,等.改良腹腔镜技术在高位复杂膀胱阴道瘘修补术中的应用[J].中华泌尿外科杂志,2018,39(8):565.
[17] Aguilar PR,Bemiss BC,Witt C,et al.Impact of delayed chest closure on surgical site infection after lung transplantation[J].Annals of Thoracic Surgery,2017,104(4):1208.
[18] 张佳宇,宋 彬,高硕徽,等.胃癌患者腹腔镜胃癌根治术后感染病原菌分布及危险因素分析[J].中国实验诊断学,2016,20(9):1474-1476.
[19] 李 杨,张忠民,王少勇,等.直肠癌腹腔镜手术与开腹手术后切口愈合不良发生率的对比研究[J].贵州医药,2020,44(1):33-34.
[20] 闫峥峥,贺杰峰,邢 君.经皮经肝胆囊穿刺置管引流术后早期和延期腹腔镜胆囊切除术在年龄≥65岁急性重症胆囊炎患者中应用价值的前瞻性研究[J].中华消化外科杂志,2019,18(5):447-452.

相似文献/References:

[1]张 毅,闫国诚,王双全.改良五孔法腹腔镜手术路径在胆囊并胆总管结石治疗中的应用研究*[J].陕西医学杂志,2019,(3):311.
[2]胡诗婉.腹腔镜下手术联合应用甲氨蝶呤对异位妊娠患者生殖能力及生育结局的影响研究*[J].陕西医学杂志,2019,(12):1667.
[3]焦明娜,霍红艳.氢吗啡酮复合右美托咪啶对老年腹腔镜胃肠道手术患者血流动力学、镇痛效果和不良反应的影响[J].陕西医学杂志,2023,52(2):200.[doi:DOI:10.3969/j.issn.1000-7377.2023.02.019]
 JIAO Mingna,HUO Hongyan.Effects of hydromorphone combined with dexmedetomidine on hemodynamics,analgesia and adverse reactions in elderly patients with laparoscopic gastrointestinal surgery[J].,2023,52(11):200.[doi:DOI:10.3969/j.issn.1000-7377.2023.02.019]

备注/Memo

备注/Memo:
基金项目:陕西省教育厅重点实验室科研计划项目(15JS025)
更新日期/Last Update: 2021-11-05